Wealthier elders are significantly less likely than poorer ones to suffer pain at the end of their lives, according to a University of Michigan study forthcoming in the August issue of the Journal of Palliative Care.
Specifically, men and women age 70 or older whose net worth was $70,000 or higher were 30 percent less likely than poorer people to have felt pain often during the year before they died. This difference persisted after the researchers controlled for age, gender, ethnicity, education and diagnosis.
Wealthier elders also experienced a lower number of symptoms overall, the study found. Those in the wealthiest half of the elderly population not only had less pain, but were less likely to suffer from shortness of breath and depression.
"Regardless of wealth, older Americans carry an unacceptable burden of suffering in their last year of life," said Maria Silveira, a physician at the Veterans Affairs Ann Arbor Healthcare System, a research scientist at the U-M and the lead author of the study. "The older adults we studied who lived in the community suffered as much in their last year of life as do younger people who are severely ill and hospitalised."
The study was based on an analysis of data on 2,604 men and women age 70 or older who died between 1993 and 2000. They were part of the Health and Retirement Study conducted by the U-M Institute for Social Research (ISR).
To break the connection between wealth and suffering at the end of life, the government might consider expanding Medicare to include medications, or expanding the criteria for hospice to include older adults with significant symptoms, regardless of their prognosis. Currently, hospice treatment is covered only for those whose physicians certify to have less than six months to live.
"This would enable older adults to access medications regardless of ability to pay," Silveira said. "It would also improve access to services for underserved and vulnerable populations."
MEDICA.de; Source: Michigan Institute for Social Research