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

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

(Dave Ogilvie/Contributed)
Injured mountain biker rescued in West Kelowna

The mountain biker reportedly has a hip injury about 1 km up the Smith Creek Road trail

Emily Steele holds up a collage of her son, 16-year-old Elijah-Iain Beauregard who was stabbed and killed in June 2019, outside of Kelowna Law Courts on June 18. (Aaron Hemens/Capital News)
Kelowna woman who fatally stabbed Eli Beauregard facing up to 1.5 years of jail time

Her jail sentence would be followed by an additional one to 1.5 years of supervision

This undated file photo provided by Ernie Carswell & Partners shows the home featured in the opening and closing scenes of The Brady Bunch in Los Angeles. Do you know the occupation of Mike Brady, the father in this show about a blended family? (Anthony Barcelo/Ernie Carswell & Partners via AP, File)
QUIZ: A celebration of dad on Father’s Day

How much do you know about famous fathers?

Asia Youngman (right) is pictured shooting another short film she wrote and directed titled Hatha. (Luba Popovic)
Peachland set to star in fantasy thriller film about N’xaxaitk’w — a.k.a. the Ogopogo

The film will follow an Indigenous teen as she navigates peer pressure, bullying and identity

Fruit farmers in the Okanagan and Creston valleys are in desperate need of cherry harvesters amid COVID-19 work shortages. (Photo: Unsplash/Abigail Miller)
‘Desperate’ need for workers at Okanagan cherry farms

Fruit farmers are worried they’ll have to abandon crops due to COVID-19 work shortages

Marco Mendicino, Minister of Immigration, Refugees and Citizenship during a press conference in Ottawa on Thursday, May 13, 2021. THE CANADIAN PRESS/Sean Kilpatrick
Canada to welcome 45,000 refugees this year, says immigration minister

Canada plans to increase persons admitted from 23,500 to 45,000 and expedite permanent residency applications

Jeanette Megens
KCR: Volunteering is sharing your story

Kelowna Community Resources shares stories of its volunteers in a weekly column

FILE – Most lanes remain closed at the Peace Arch border crossing into the U.S. from Canada, where the shared border has been closed for nonessential travel in an effort to prevent the spread of the coronavirus, Thursday, May 7, 2020, in Blaine, Wash. The restrictions at the border took effect March 21, while allowing trade and other travel deemed essential to continue. (AP Photo/Elaine Thompson)
Feds to issue update on border measures for fully vaccinated Canadians, permanent residents

Border with U.S. to remain closed to most until at least July 21

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

A portion of the George Road wildfire burns near Lytton, B.C. in this Friday, June 18, 2021 handout photo. THE CANADIAN PRESS/HO, BC Wildfire Service *MANDATORY CREDIT*
Blaze near Lytton spread across steep terrain, says BC Wildfire Service

Fire began Wednesday and is suspected to be human-caused, but remains under investigation

Jaimee Peters photo of a Willow Midwives helping with a birth. Willow closed its doors March 31 because of a shortage of midwives. (Contributed)
South Okanagan’s only midwifery to re-open this summer

Willow Community Midwives was forced to close because of a shortage of midwives

Blair Lebsack, owner of RGE RD restaurant, poses for a portrait in the dining room, in Edmonton, Friday, June 18, 2021. Canadian restaurants are having to find ways to deal with the rising cost of food. THE CANADIAN PRESS/Jason Franson
Canadian restaurateurs grapple with rising food costs, menu prices expected to rise

Restaurants are a low margin industry, so there’s not a lot of room to work in additional costs

Gord with a mom and her young son outside Pathways which was defunded on May 31. (Facebook)
Gord Portman with a mom and her child outside of Pathways. The sign says it all about the difference Pathways has made in people’s lives. They were defunded by Interior Health on May 31.
Penticton man takes the plunge for the recovery house that helped save his life

Gord Portman said Discovery House and Pathways have been everything in his 1 year sobriety

Most Read