At least 15% of deaths among nursing home residents are premature, usually injury-related, and potentially preventable, according to the Australian authors of the first study of its kind.
The incidence of premature and potentially preventable deaths of nursing home residents has increased over the past decade, they also warned, based on their analysis.
“We have our first real understanding of how many deaths are occurring in nursing homes that shouldn’t be happening”
The researchers said their national study was the first in the world to look at potentially preventable deaths in nursing homes using information from medico-legal investigations.
Such “external deaths” – for example, from falls, choking, suicide and murder – accounted for almost 3,300 deaths of nursing home residents over a 13-year period.
It also revealed a more than 400% increase in the incidence of premature and potentially preventable deaths of Australian nursing home residents over the past decade.
The study was led by Professor Joseph Ibrahim, from the Monash University’s faculty of medicine and nursing, and has been published in the Medical Journal of Australia.
It used coronial data to review the deaths by external causes of all of nursing home residents between 2000 and 2013.
The study found that, of the 21,672 deaths of residents reported to the Coroners Court over the 13 years, 3,289 (15.2%) were from external or preventable causes, and almost all were unintentional.
Of those deemed unintentional, 81.5% died as a result of falls and 7.9% died of choking. Somewhat surprising, said the researchers, was the small number (1.2%) who died from complications of clinical care.
For intentional deaths that were seen as preventable, 4.4% were from suicide and 1% were from resident-to-resident assault.
Professor Ibrahim cautioned that the overall figure was probably an under estimate owing to some deaths being misclassified as “natural”.
This, he suggested, was due to the tendency for health professionals and society to downplay the significance of the injury-related factors – tending to assume old age and any underlying illness were the explanation for deaths.
Call to reduce ‘preventable’ deaths in nursing homes
Professor Ibrahim called for national strategies to reducing unnecessary deaths in nursing homes, with a body made responsible “for reducing harm by improving practice in nursing homes”.
“Improving the quality of care for nursing home residents requires a better understanding of how, why, where and when they die,” he said. “The global population is ageing rapidly, and the need for aged care services is consequently increasing.
“With this study we have our first real understanding of how many deaths are occurring in nursing homes that shouldn’t be happening,” said Professor Ibrahim.
“However, there is a paucity of information about the cause and manner of premature deaths of nursing home residents from which we can review how these operations are run,” he added.
Professor Ibrahim acknowledged that the increased number of preventable deaths identified may be, in part, due to increased scrutiny of aged care facilities by the community and government.