{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:39:51Z","timestamp":1792463991626,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Little is known about whether primary caregiver relationship is associated with hospice use or advance care planning (ACP) in later life. This study examined variation in hospice use and ACP across primary caregiver relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Gateway Harmonized Health and Retirement Study End\u2010of\u2010Life data were restricted to Wave 12 and later. The\u00a0sample included 3952 decedents aged 60\u2009years or older. Caregiving category identified the primary caregiver as spouse\/partner, child\/grandchild, extended family, or non\u2010kin informal, with formal care only and no identified caregiver as additional categories. Multivariable logistic regression estimated hospice use; a joint Wald test assessed overall differences across\u00a0four informal primary\u2010caregiver categories, and probability\u2010scale decomposition examined indirect associations through ACP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among decedents with an identified informal primary caregiver, hospice use did not vary overall by caregiver relationship. Relative to spouse\/partner primary caregiving, hospice use was lower among decedents with no identified caregiver (OR, 0.46) and those receiving formal care only (OR, 0.62), while child\/grandchild primary caregiving was associated with a 3.87\u2010percentage\u2010point higher probability of ACP. The indirect association through ACP for child\/grandchild primary caregiving was small (0.39 percentage points).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hospice use was not concentrated within a particular informal primary caregiver relationship, whereas differences by caregiver relationship were more apparent in ACP. These findings highlight a distinction between care planning and eventual service use and suggest that caregiver availability and broader caregiving circumstances may be important to consider alongside relationship type.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70791","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:58:43Z","timestamp":1792461523000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Caregiving Relationships, Advance Care Planning, and Hospice Use in Later Life"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4549-5017","authenticated-orcid":false,"given":"Yanjun","family":"Dong","sequence":"first","affiliation":[{"name":"School of Social Welfare, College of Integrated Health Sciences University at Albany, State University of New York  Albany New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5637-3912","authenticated-orcid":false,"given":"Hillary D.","family":"Lum","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Geriatrics University of Colorado Anschutz Medical Campus  Aurora Colorado 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