Men with dementia treated much differently than women: Ontario care home study

Research suggests men more likely to be transferred to hospital emergency ward, receive antibiotics

A hospital room at St. Michael’s Hospital in Toronto. THE CANADIAN PRESS/ Tijana Martin

Researchers say they’ve discovered profound gender differences in the way Ontario nursing home residents with advanced dementia receive care in their final days — findings they say highlight a stark divide in the way men and women receive care and regard their own deaths.

Doctors with the Ontario non-profit research institute ICES released a study Friday that found male nursing home residents with advanced dementia were more likely to be hospitalized, physically restrained and receive invasive treatment than female residents in the last 30 days of life.

Lead author Dr. Nathan Stall said the data points to gender biases that are known to occur more broadly in health care, in which men are often offered more aggressive treatment than women with similar conditions.

While such interventions might be welcome earlier in life, they are often avoidable and distressing later in life and may not provide comfort if the patient is near death, said Stall, noting that by this point the resident is often frail and cognitively impaired.

“The care should generally be focused at this stage on maximizing quality of life,” said Stall.

The study looked at the experiences of 27,243 nursing home residents with advanced dementia who died between June 1, 2010, and March 31, 2015. It was published Friday in the medical journal JAMA Network Open.

READ MORE: Feds announce $50M strategy to fight dementia

Stall said men were 41 per cent more likely to be transferred to an emergency department or hospital, and were 33 per cent more likely to receive antibiotics, the administration of which can be painful for seniors who require it intravenously.

The study also questioned how often antibiotics are appropriate, noting “they are often prescribed in the absence of strong evidence for bacterial infection.” The “indiscriminate use of antibiotics in nursing homes” is also linked to the spread of multidrug-resistant organisms, researchers said, posing a “major public health threat.”

Researchers suspected unconscious gender biases were at play when it came to delivery of care.

The study cited another paper on people who complained about osteoarthritis, finding that even when presenting similar symptoms, men were more likely to be offered a joint replacement, while women were more likely to be offered physical therapy and supportive therapy.

“We know that men are more likely to be described as ‘the fighter’ than women are,” said Stall. “How does that result in people receiving interventions (at the) end of life?”

The study found that male residents were more likely to die in an acute-care facility, instead of their nursing home, and that overall, only a minority of residents saw a palliative care doctor in the year before death.

Those who did see a palliative care doctor were half as likely to be transferred to an emergency room or hospital, and 25 per cent less likely to receive antibiotics.

Stall said men and women also tend to regard death differently, with women tending to be less afraid of death and more likely to refuse intubation and CPR at the end of life.

In Canada, approximately 564,000 people were living with dementia in 2016, a number that is expected to increase to 937,000 by 2031.

Most people with dementia are older adults, two-thirds of whom are women.

Cassandra Szklarski, The Canadian Press

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Island teen climber seizes last opportunity to qualify in 2020 Olympic games

Brennan Doyle, 16, heads to L.A. for Pan American Climbing Championships

University of Victoria profs take home prestigious national teaching award

Brent Mainprize and Edōsdi–Judy Thompson recognized as a 2020 3M National Teaching Fellows

Victoria modular housing complex built to house homeless Indigenous women

Spa’Qun, or ‘Flower House’ will provide shelter and cultural support

Loans or gifts? Judge rules woman must pay Victoria man back $7K

B.C. judge rules that woman must pay back more than $7,000 in advanced funds to man

Alice Munro among Nobel Prize winners urging Trudeau to deny oilsands project

Alberta premier says Teck’s Frontier mine would create 7,500 jobs, $70 billion in government revenue

VIDEO: B.C. senior recalls ‘crazy’ wartime decision to grab bear cub from den

Henry Martens – now 96 – says he was lucky to be alive after youthful decision to enter a bear’s den

Cheapest in B.C.: Penticton gas prices dip below $1 per litre

Two stores in Penticton have gas below a dollar.

VIDEO: Outpouring of worldwide support for bullied Australian boy

Australian actor Hugh Jackman said ‘you are stronger than you know, mate’

‘A horror show:’ Ex-employee shares experience at problematic Chilliwack seniors’ home

Workers are paid below industry standard at all Retirement Concepts facilities

Forest industry protests northern B.C. caribou protection deal

B.C. Mining Association supports federal-Indigenous plan

Youth-led report calls on B.C. government to create plan to end youth homelessness

There are no dedicated programs for youth homelessness at federal, provincial level, report says

UPDATE: Lockdown lifted at Nanaimo high school following threats

Nearby elementary school was in hold-and-secure

Trudeau: Time for blockades to end and Indigenous leaders to work with government

Prime minister says situation in Coastal GasLink pipeline dispute is ‘unacceptable and untenable’

POLL: Do you support the proposed changes for ICBC?

Tuesday’s provincial budget predicted a shift from shortfall to surplus in wake… Continue reading

Most Read