Nwamaka Eneanya, MD: A Closer Look at End of Life Care for Veterans

New data shows that minority veterans are more likely than non-minorities to use palliative care or hospice at the end of their lives.

During the American Society of Nephrology (ASN) Kidney Week in Washington, D.C., Nwamaka Eneanya, MD, assistant professor of Medicine, the Hospital of the University of Pennsylvania, explained in an interview with MD Magazine® the results of the new study focusing on non-dialysis-dependent veterans with chronic kidney disease.

MD Magazine: On the new study looking at disparities for veterans in terms of end-of-life care.

Eneanya: So, we wanted to look at disparities in end-of-life care, so care received at the end of life for patients who had advanced kidney disease but were not yet on dialysis.

We know that there's been a lot of studies that show that dialysis patients tend to die in the hospital, tend to receive CPR, mechanical ventilation more than other seriously ill populations.

We really want to focus on elderly patients who don't use dialysis because that is a little bit more unknown in terms of what their care looks like and if there's racial disparities in that.

MD Magazine: On racial disparities of outcomes within this patient population.

Eneanya: In the general literature for the most part racial and ethnic minorities tend to not have access to palliative care.

They tend to not use hospice as much and then they tend to receive more intense care at the end of life, die in the hospital. When you poll the general public, most people do not want to have a medicalized death and die in the hospital.

So consistently we see that blacks, Hispanic patients tend to have more intense care and so they are there at a disservice and for that reason.

MD Magazine: Is there a difference between the general population and veterans in end-of-life care?

Eneanya: Not necessarily. So, when we look at end-of-life care for the veteran population it's similar. It's not perfectly similar to the civilian population, but there's similar trends in terms of intensity of care at the end of life. It is very similar.