A Commentary

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Abstract
The limited data about the epidemiology concerning the settings where elderly persons die include a variety of social, cultural, and economic factors. Unfortunately, even less is known about the interplay among these factors. Approximately two thirds of all cancer patients prefer, but often do not succeed in, dying at home (Gallo, Baker, and Bradley 2001; McCusker 1983; Tang and McCorkle 2001). The purpose of this article is to provide a survey of current literature reviewing the social and cultural determinants as they relate to the settings where elderly individuals in the United States die. Given the paucity of data in this subject area, the review will include research conducted over the past 20 years. The problem with this approach is the profound economic and technological advances that have occurred in the health care delivery system and that in turn have affected how and where we spend our last days of life. We will use the model of Mor and Hiris 1983 that outlines possible factors for choices of settings at the end of life: (a) sociodemographic characteristics of the patient, (b) characteristics of available support networks, (c) measures of functional characteristics and degree of dependence on support network, and (d) health system and institutional factors.

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