A study of nursing home residents with advanced dementia found men were more likely to be hospitalized, physically restrained and receive invasive treatment in their final days.

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Conducted by the world renowned Institute for Clinical Evaluative Sciences or ICES, in Toronto, researchers found men were also more likely to die in an acute-care facility instead of their nursing home.

They say their findings point to gender biases that are known to occur more broadly in healthcare, and while such interventions may be welcome earlier in life, they’re often avoidable and distressing later in life, and may not provide comfort if the patient’s near death.

Researchers say it also highlights the need to discuss end-of-life wishes with loved ones and caregivers.

The study looked at the experiences of 27,243 nursing home residents with advanced dementia over a period of nearly five years.

The findings are in the medical journal JAMA Network Open.