As elderly adults approach the end-of-life, gender biases may play a significant role in how aggressive treatments are to extend life, and they may cause men more unnecessary suffering than women with similar conditions. According to a recent CTV News report, an Ontario nursing home study found that men with advanced dementia were 41 percent more likely to be sent to an emergency room in their last days of life than women and 33 percent more likely to receive antibiotics. But why are elderly men treated differently than women?
The lead author of the Institute for Clinical Evaluative Sciences (IC/ES) research, Nathan M. Stall, studied a group of 27,243 deceased male and female nursing home residents with a median age of 88. Men in the study with advanced dementia were significantly more likely to experience invasive interventions, be physically restrained or sent to the emergency room than women in similar circumstances. It is suggested that women are more at peace and accepting of the end of life and their medical care tends to focus more on comfort and quality of life rather than aggressive treatment. Men, however, are often perceived as “fighting until the end” and as a result may experience a poorer quality of life and be given aggressive treatment that causes unnecessary suffering for both patients and their families.
But when nursing home residents with advanced dementia have only an average survival time of 1.3 years while experiencing a serious loss in their ability to perform daily activities, communicate with others or move around without assistance, why are so many men receiving these aggressive treatments? As more adults live into very old age, a shift is beginning to take place in geriatric health care that focuses more on palliative care and quality of life. This study, which highlights the gender differences in end-of-life care, is one more step along the path to creating care plans that focus on patients experiencing a better death rather than having their life extended at any cost.
Although women may be more likely to talk frankly with their loved ones about their end-of-life wishes, it’s important that older adults of both sexes create an advanced care directive that lets families know exactly what interventions would or would not be wanted by the patient, especially in the case of advanced dementia. Learn more about living wills and advance directives for medical decisions by following this link to the Mayo Clinic’s Healthy Lifestyle page.