Factors affecting hospice care use among long-term care facility residents in Canada

Hospice care can improve quality of life for persons nearing end of life. Little is known about hospice care practices in long-term care facilities (LTCFs) in Canada. This thesis included 185,715 residents in LTCFs in Canada in 2015 and followed their death records to 2016 to examine the characteristics of residents who received hospice care and those who did not but may have benefitted from it. Univariate, bivariate and multivariate analyses were used depending on the variable type. Results show the actual use of hospice care in LTCFs is very low in Canada (i.e. less than 3%). Residents who received hospice care had more severe and complex clinical needs than those who did not. Findings suggest several possible barriers to hospice use in the LTCF population including ageism, rurality, and disease diagnoses. Immediate action is needed to provide improved access to, and utilization of, hospice care in LTCFs in Canada.