Innovations in Dying in the Nursing Home: The Impact of Market Characteristics

Abstract

During the 1980s nursing homes emerged as a dominant site of death for the elderly. This may precipitate more innovative approaches to death and dying in the nursing home and may account for the recent emergence of hospice care and pain management programs in nursing homes. However, the provision of hospice care and pain management in nursing homes are trends about which we have virtually no information. As a first step in examining these phenomena we provide a descriptive analysis of nursing homes that provide hospice care or pain management programs and an analysis of the impact of market characteristics as determinants of nursing homes providing them. Our findings suggest that the provision of pain management programs and hospice care are becoming prevalent in nursing home settings and that nursing homes are quite sensitive to their market environment indicating that policy changes could encourage further increases in these service innovations in death and dying.