Palliative Needs Among Home Care Clients from Underserved Groups: A Cross-Sectional Study.

Area of Science:

• Gerontology
• Health Services Research
• Public Health

Background:

• Palliative care (PC) enhances quality of life by promoting dignity and comfort.
• Certain populations, including those with mental illness, dementia, linguistic minorities, and rural residents, face palliative care inequities.
• Data on palliative needs within underserved Canadian groups is limited.

Purpose of the Study:

• To examine the prevalence of palliative needs in Canadian home care clients.
• To investigate associations between belonging to an underserved group and the recognition of palliative needs.
• To identify disparities in palliative care recognition among diverse populations.

Main Methods:

• Analysis of anonymized pan-Canadian population-level data from 1,451,135 home care clients.
• Definition of palliative needs included a prognosis of ≤6 months, palliative goals of care, or receipt of hospice/palliative services.
• Statistical analysis controlled for demographic, social, functional, and clinical characteristics.

Main Results:

• Overall, 5.0% of home care clients had recognized palliative needs.
• Older adults (85+), individuals with dementia, mental illness, or from linguistic minorities had decreased odds of recognized palliative needs.
• Individuals in rural areas showed slightly increased odds of recognized palliative needs.

Conclusions:

• Findings indicate that palliative needs may be unrecognized in specific underserved groups, potentially leading to inadequate care.
• There is a critical need for enhanced identification and awareness of palliative needs in vulnerable populations.
• Future research should focus on strategies for earlier and more equitable recognition of palliative care needs.