Feature ArticlesComplex Care Needs at the End of Life for Seriously Ill Adults With Multiple Chronic ConditionsMurali, Komal Patel PhD, RN, ACNP-BC; Merriman, John D. PhD, RN; Yu, Gary DrPH; Vorderstrasse, Allison DNSc, RN, FAAN; Kelley, Amy S. MD, MSHS, FAAHPM; Brody, Abraham A. PhD, RN, FAAN Author Information Komal Patel Murali, PhD, RN, ACNP-BC, is assistant professor, New York University Rory Meyers College of Nursing. John D. Merriman, PhD, RN, is assistant professor, New York University Rory Meyers College of Nursing. Gary Yu, DrPH, is associate research scientist, adjunct associate professor, New York University Rory Meyers College of Nursing. Allison Vorderstrasse, DNSc, RN, FAAN, is professor and dean, University of Massachusetts Amherst Elaine Marieb College of Nursing. Amy S. Kelley, MD, MSHS, FAAHPM, is professor, Icahn School of Medicine at Mount Sinai Brookdale Department of Geriatrics and Palliative Medicine. Abraham A. Brody, PhD, RN, FAAN, is Mathy Mezey professor of Geriatric Nursing, associate director, Hartford Institute of Geriatric Nursing, New York University Rory Meyers College of Nursing, and Professor of Medicine, New York University Grossman School of Medicine. Address correspondence to Komal Patel Murali, PhD, RN, ACNP-BC, New York University Rory Meyers College of Nursing, 433 1st Ave, New York, NY 10010 ([email protected]). This work was supported by the National Center for Advancing Translational Sciences, National Institute for Nursing Research, and the National Institute on Aging. K.P.M. was a doctoral student supported by the NYU Clinical and Translational Science Institute (NCATS/NIH: TL1 TR001447; UL1 TR001445) and was supported by the Columbia Nursing Comparative and Cost-Effectiveness Research Training Program for Nurse Scientists (CER2) (T32NR014205). A.S.K. was supported by the National Institute on Aging (K24AG062785). Data statement: Deidentified data are available through the Palliative Care Research Cooperative Group. Clinical Trial Registration: This was a secondary data analysis of a clinical trial. The trial was registered on clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT01415934. The authors have no conflicts of interest to disclose. Journal of Hospice & Palliative Nursing 25(3):p 146-155, June 2023. | DOI: 10.1097/NJH.0000000000000946 Buy Metrics Abstract Understanding the complex care needs of seriously ill adults with multiple chronic conditions with and without cancer is critical for the delivery of high-quality serious illness and palliative care at the end of life. The objective of this secondary data analysis of a multisite randomized clinical trial in palliative care was to elucidate the clinical profile and complex care needs of seriously ill adults with multiple chronic conditions and to highlight key differences among those with and without cancer at the end of life. Of the 213 (74.2%) older adults who met criteria for multiple chronic conditions (eg, 2 or more chronic conditions requiring regular care with limitations of daily living), 49% had a diagnosis of cancer. Hospice enrollment was operationalized as an indicator for severity of illness and allowed for the capture of complex care needs of those deemed to be nearing the end of life. Individuals with cancer had complex symptomatology with a higher prevalence of nausea, drowsiness, and poor appetite and end of life and lower hospice enrollment. Individuals with multiple chronic conditions without cancer had lower functional status, greater number of medications, and higher hospice enrollment. The care of seriously ill older adults with multiple chronic conditions requires tailored approaches to improve outcomes and quality of care across health care settings, particularly at the end of life. Copyright © 2023 by The Hospice and Palliative Nurses Association. All rights reserved.