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

Just Posted

Impaired driver causes power outage in Vanderhoof

Resident did not have power from 2:00 am until 3:17 am

‘It affects everybody:’ Trudeau’s brownface photos worry Wet’suwet’en chief

Skeena-Bulkley Valley Liberal candidate declines to comment on prime minister’s indiscretion

B.C. offers early retirement, training fund for forest workers

Communities eligible for $100,000 for permanent closures

Photo Gallery: Terry Fox Run in Vanderhoof

Residents run to support cancer research

Vanderhoof runners win big at racing event held in Prince George

Brian Nemethy wins the 14 km men’s race for the fourth time and Nolan McCleary secured gold in the 5 km run for the second time.

VIDEO: Grizzly bears fight along northern B.C. highway in rare footage

Cari McGillivray posted the head-turning video, shot near Stewart, B.C., to social media

Handgun crackdown, health spending and transit plans latest campaign promises

Friday was the end of a busy week on the campaign trail

B.C. woman photographs massive ant swarm on Abbotsford driveway

She asked what the ants were doing? The answer: war

Police arrest B.C. phone scammer linked to illegal call centres in India

Person arrested in Burnaby here on a work visa, says police

Air Canada forced girl, 12, to remove hijab: civil rights group

The San Francisco Bay Area office of the Council on American-Islamic Relations calling for change

Man from Winnipeg who was hiking alone found dead in Banff National Park

RCMP say the man was hiking alone on Mount Temple Thursday

Takaya, B.C.’s intriguing lone wolf, seen eating seal and howling away on Discovery Island

Fun facts about Takaya the wolf, like his a 36-hour tour around Chatham, Discovery Islands

Resident finds loaded shotgun inside a duffle bag in Kelowna alleyway

RCMP seized a loaded 12-gauge shotgun, ammunition, clothing and other items

Graffiti, calls and Snapchat: RCMP probe string of threats targeting Kamloops schools

There have been nine different threats made to four different schools in the city

Most Read