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Last rights: a study of how death and dying are handled in residential care and nursing homes
- Author:
- COUNSEL AND CARE
- Publisher:
- Counsel and Care
- Publication year:
- 1995
- Pagination:
- 54p.,bibliog.
- Place of publication:
- London
Report of a study of how death is faced and supported in 6 residential care and nursing homes, providing models of good practice.
Rapid decrease in length of stay in institutional care for older people in Sweden between 2006 and 2012: results from a population-based study
- Author:
- SCHON Par
- Journal article citation:
- Health and Social Care in the Community, 24(5), 2016, pp.631-638.
- Publisher:
- Wiley
There is limited knowledge about older people's length of stay (time until death) in institutional care and how it has changed over time. The aim of this study was to analyse changes in the length of stay for older people in institutional care between 2006 and 2012. All persons 65+ living in Kungsholmen (an urban area of Stockholm), who moved to an institution between 2006 and 2012, were included (N = 1103). The data source was the care system part of a longitudinal database, the Swedish National Study on Aging and Care. The average length of stay was analysed using Laplace regression for the 10th to the 50th percentile for the years 2006–2012. The regressions showed that in 2006, it took an average of 764 days before 50% of those who had moved into institutional care had died. The corresponding figure for 2012 was 595 days, which amounts to a 22.1% decrease over the period studied. For the lower percentiles, the decrease was even more rapid, for example for the 30th percentile, the length of stay reduced from 335 days in 2006 to 119 days in 2012, a decrease of 64.3 per cent. The most rapid increase was found in the proportion that moved to an institution and died within a short time period. In 2006, the first 10% had on average died after 85 days, in 2012 after only 8 days; a decrease in the length of stay of 90.5 per cent. In general, there was a significant decrease in the length of stay in institutional care between 2006 and 2012. The most dramatic change over the period studied was an increase in the proportion of people who moved into an institution and died shortly afterwards. (Edited publisher abstract)
Factors affecting survival of elderly nursing home residents
- Authors:
- DALE Mark C., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(1), January 2001, pp.70-76.
- Publisher:
- Wiley
This article examines whether the admission characteristics of nursing home residents predict mortality and to look for factors that account for different mortality rates between those homes. It uses a retrospective case note audit of the admission characteristics of residents in nursing homes registered with the Manchester Health Authority who died within a 12 month period and a group of current residents matched by age, sex and length of stay. Time between admission and death was examined using actuarial estimators of survival and factors predicting time between admission and death were examined using a proportional hazards model. Some nursing homes have higher mortality rates than others although this was accounted for by the characteristics of the residents and not by any measurable characteristic of the nursing home environment.
International data on deaths attributed to COVID-19 among people living in care homes
- Authors:
- COMAS-HERRERA Adelina, et al
- Publisher:
- International Long Term Care Policy Network
- Publication year:
- 2022
- Place of publication:
- London
This post presents a compilation of official international data on deaths attributed to COVID-19 among people living in care homes. There seem to be fewer countries regularly reporting data on COVID-19 related deaths among care home residents publicly than earlier in the pandemic, but we have been able to find data for 21 countries, including some we had not found in previous reports such as Luxembourg (we had found data for 22 countries in previous reports). The share of all COVID-19 related deaths who were care home residents has decreased in most countries since the middle of 2021, reflecting that in many countries people living in care homes were given priority for COVID-19 vaccination and, later on, booster doses, and efforts to improve infection prevention and control in care homes. The strong correlation between the number of COVID-19 deaths among people living in the community and among care home residents remains, highlighting the importance of community transmission despite all the measures to protect care homes. Comparing the cumulative number of deaths linked to COVID-19 among care home residents and the numbers of people who were living in care homes close to the beginning of the pandemic gives an idea of the scale of the mortality impact of COVID-19 among the care home population. So far the ration between cumulative deaths of care home residents linked to COVID-19 and the number of people living in care home is over 1 in 10 in Belgium, Slovenia, England, Scotland and the United States. So far the data gathered in our reports, for the few countries we can cover, show that at least 421,959 people who lived in care homes died linked to COVID-19 so far. This is equivalent to the entire population of cities like San Juan (Puerto Rico), Bratislava (Slovakia), Auckland (New Zealand) and Oakland (United States). (Edited publisher abstract)
Who's death is it?
- Author:
- DONOVAN Paul
- Journal article citation:
- Community Care, 5.8.99, 1999, p.11.
- Publisher:
- Reed Business Information
Asks why care assistants are expected to take the responsibility for identifying death when residents die outside of surgery hours.
Unexplained absence resulting in deaths of nursing home residents in Australia: a 13‐year retrospective study
- Authors:
- WOOLFORD Marta H., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(8), 2018, pp.1082-1089.
- Publisher:
- Wiley
Objectives: To examine deaths of Australian nursing home (NH) residents following an unexplained absence. Methods: Population based cross‐sectional study was conducted using coronial data from the National Coronial Information System. Participants are residents of accredited NHs if death followed an unexplained absence and was reported to the Coroner between July 1, 2000 and June 30, 2013. Individual, organisational, environmental, and unexplained absence event factors were extracted from coronial records. Data were analysed using descriptive statistics. Results: Of 21 672 NH deaths, 24 (0.1%) followed an unexplained absence. This comprised 17 unintentional external (injury‐related) causes and 7 natural cause deaths. Drowning was the most frequent external cause of death (59%, n = 10). Deaths occurred more frequently in males (83.3%, n = 20), and in the age group 85‐94 years (37.5%, n = 9). The majority of NH residents, for whom data were available (n = 15), had a diagnosis of dementia (86.7%, n = 13). Most residents were found in waterways (41.7%, n = 10). Median distance travelled was 0.5 km (IQR: 0.25‐2.4 km), with almost 70% of residents found within 1.0 km of their NH. Most residents left the NH by foot (88.2%, n = 15). Half of the residents were found within 6 hours of time last seen (median: 6 hours, 40 minutes; IQR: 6.0‐11.45 hours). Conclusion: Unexplained absences in elderly NH residents are a relatively common event. This study provides valuable information for aged care providers, governments, and search and rescue teams, and should contribute to debates about balancing issues of safety with independence. (Edited publisher abstract)
UK care home providers for the elderly: consumer law advice on the charging of fees after death. Helping care home providers comply with their consumer law obligations
- Author:
- COMPETITION AND MARKETS AUTHORITY
- Publisher:
- Competition and Markets Authority
- Publication year:
- 2018
- Pagination:
- 18
- Place of publication:
- London
Advice to help providers of residential care home and nursing home services for people in the UK over 65 understand and comply with their responsibilities under consumer law following the death of a resident. The advice relates to self-funded and part-funded residents. The main issue covered is the maximum length of time care homes can reasonably continue to charge fees following the death of a resident. The advice also covers the treatment of residents’ possessions and the transparency of related terms in your contracts with residents. (Edited publisher abstract)
A greater risk of premature death in residential respite care: a national cohort study
- Authors:
- WILLOUGHBY Melissa, et al
- Journal article citation:
- Age and Ageing, 47(2), 2018, pp.226-233.
- Publisher:
- Oxford University Press
Background: The demand for residential respite care for older persons is high yet little is known about the occurrence of harm, including death in this care setting. Objective: To compare the prevalence and nature of deaths among residential respite to permanent nursing home residents. Design: Retrospective cohort study. Setting: Australian accredited nursing homes between 1 July 2000 and 30 June 2013. Subjects: Respite and permanent residents of Australian accredited nursing homes, whose deaths were investigated by Australian coroners. Methods: Prevalence of deaths of nursing home residents were calculated using routinely generated coronial data stored in the National Coronial Information System. Odds ratios (OR) were calculated to examine residency (respite or permanent) by cause of death. Results: Of the 21,672 residents who died during the study period, 172 (0.8%) were in respite care. The majority of deaths were due to natural causes. A lower proportion occurred in respite (n = 119, 69.2%) than permanent (n = 18,264, 84.9%) residents. Falls-related deaths in respite as a proportion (n = 41, 23.8%) was almost double that in permanent care (n = 2,638, 12.3%). Deaths from other injury-related causes (such as suicide and choking) were significantly more likely in respite residents. Conclusions: This is the first national cohort study examining mortality among respite residents. It established that premature, injury-related deaths do occur during respite care. This is the first step towards better understanding and reducing the risk of harm in respite care. (Edited publisher abstract)
Premature and preventable deaths in frail, older people: a new perspective
- Authors:
- HITCHEN Tatiana, et al
- Journal article citation:
- Ageing and Society, 37(8), 2017, pp.1531-1542.
- Publisher:
- Cambridge University Press
The concept and potential implications of a premature death of an older person are under-recognised and misunderstood by society. Clinical, forensic and public health practitioners need to redress this gap to prepare society better for a future where an increasing proportion of the population are vulnerable older people. Reliable and valid information is paramount for understanding how many older people have premature, preventable deaths, with implications for aged care services, health-care expenditure, quality and safety, and human rights. The authors' aim is to: (a) provide discourse on the limitations and challenges to the use of the concepts ‘premature’ and ‘preventable’ deaths, examining the situation for nursing home residents; and (b) propose the use of a novel classification system of ‘treated’, ‘un-treated’ and ‘untreatable’ causes of death that is more sophisticated and reflects the demographic reality of our ageing population. Accepting that preventable, premature deaths may happen to older people and adopting a new classification is a novel approach that has considerable benefits for health and life care of older persons. Improved assessment of the quality of care provided, including identification of health or life care practices that are unsafe or deleterious, can be identified and addressed. (Edited publisher abstract)
Death and dying in residential care: a matter of concern
- Author:
- SMITH Randall
- Journal article citation:
- Quality in Ageing and Older Adults, 14(3), 2013, pp.205-217.
- Publisher:
- Emerald
Purpose – The purpose of this paper is to trace the history of official policy on the regulation of care homes in respect of end of life care and to contrast this with the results of research on this important theme, not least in terms of what is required to support care home staff in relation to dying residents and their relatives. A central concern is to argue for the open recognition that care homes now cater primarily for frail people towards the end of their lives. Good end of life care and a good death could become a positive “selling point”. The author concludes that the system of regulation has broadly failed to address a good death or good end of life care in a residential home. Death talk should no longer need to be avoided in care homes. The research suggests that appropriate support for care home staff in relation to dying residents needs careful identification and investment. A cultural shift is required. Design/methodology/approach – Following a review of policy documents on regulation and standards of care in residential homes and a subsequent review of the research literature on death and dying in care homes, the paper illuminates the contrast between the ambitious aims in policy documents with very varied practice in everyday care of frail residents. Findings – The recent systems of regulation have broadly failed to address a good death or good end of life care in residential homes. Open acknowledgement of death and dying should not be avoided in care homes. Appropriate support for care home staff in relation to dying residents needs careful identification and investment. Originality/value – The focus of this paper is to contrast official policy with everyday practice. Whilst policy documents suggest recognition of the importance of dignity and respect from dying residents, the research literature indicates great variation in the practice of everyday care. (Publisher abstract)