Monday, 25 May 2015

First of its kind study into nursing home deaths in Victoria

The Department of Forensic Medicine within SPHPM has undertaken the first comprehensive study into premature death in Victoria’s nursing homes. Professor Joseph Ibrahim led the study, with Briony Murphy, Lyndal Bugeja and David Ranson. 

The study, published in the Journal of the American Geriatrics Society, found that between 2000 and 2012 there were 1,296 external deaths in nursing homes in Victoria, and 89 per cent of those were from falls.

Professor Ibrahim said that in Australia there were more than 186,000 residents living in an estimated 2,700 nursing homes.

“This high incidence of falls-related deaths in this population compared to the general community is likely to stem from the frailty of the residents,” Professor Ibrahim said.

The study also found that 7 per cent of deaths were from choking, 1.3 per cent were suicides, 0.6 per cent were from complications in clinical care, and 0.5 per cent were by resident-resident assault. Deaths occurred more frequently in women, which is in keeping with the sex distribution in nursing home residents. The number of inquests held to investigate a death as a matter of public interest was small, a total of 24 or 1.9 per cent.

“Choking was found to be more common in young males, largely because these residents often have an acquired brain injury, which has a higher rate of swallowing disorders and risk of choking. Suicide was also more common in males, however at a lower rate than in the general community,” Professor Ibrahim said.

Australia and the world face a rapid growth in the aging population, highlighting the need for quality care for those who are in nursing homes. In 2013, there were 841 million (11.7 per cent) people aged 60 and older globally, which is expected to increase to more than 2 billion (21.1 per cent) by 2050.

Professor Ibrahim said the frailty and the presence of dementia of the aged population that is in care means that they are at greater risk of death from external causes (injury), however until now, no information about deaths in nursing homes that may be premature or preventable has been available.”
This study now provides the aged care sector and policy makers with important data that was previously unavailable, bringing to light the need for examining ways to avoid preventable harms and deaths of this vulnerable population.

Professor Ibrahim said that an evidence-based approach to identifying risk factors in aged care should be taken in order to combat those deaths that are premature and even preventable.

“There needs to be a debate over whether residents may choose activities that enhance their quality of life but increase the potential of harm or death, particularly from falls or choking.

“There must be balance between protecting residents from harm impacts and their quality of life, he said.

The study population for this retrospective cohort study were drawn from the 56,855 deaths reported to the Coroners Court of Victoria (CCOV) between 31 July 200 and 31 December 2012.

You can read the full paper here.

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