The Association Between Assisted Living Direct Care Worker End-of-Life Training and Hospice Use Patterns

As resident acuity levels increase for those who reside in assisted living (AL), states allow for hospice care provision in AL. End-of-life care training for staff can potentially increase the awareness of benefits of hospice care for AL residents. This study examined the association between AL staff trained in end-of-life care and hospice utilization in a sample of ALs (n = 45) in Florida. The sample included ALs (n = 21) with a low percentage (≤59%) and ALs (n = 24) with a high percentage (≥60%) of staff trained in end-of-life care as reported by AL directors. Zero-inflated negative binomial regression (ZINB) indicated that ALs in the high percentage of staff trained group were associated with a 3.64% greater utilization of hospice than ALs in the low percentage of staff trained group. Implementation of required staff training specific to care for the terminally ill as required in some states could potentially improve resident access to hospice care.