HEALTH

Preventable Deaths In Nursing Homes Have Quadrupled In A Decade

Almost 2,700 residents have died from falls since 2000.

29/05/2017 5:08 PM AEST | Updated 29/05/2017 5:11 PM AEST
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One in seven deaths in Australian nursing homes are 'premature', meaning they're potentially preventable.

The number of people dying prematurely from potentially preventable injuries in nursing homes has quadrupled in a decade, a landmark Australian study has found.

Almost 2,700 nursing home residents have died from injuries sustained in falls since 2000.

These are just some of the shocking statistics to emerge from a study on nursing home deaths published in the Medical Journal of Australia on Monday.

The Monash University researchers analysed the deaths of 21,672 people in nursing homes between 2000 and 2013. They ranged in age from 25 to 103 years old, although most (90 per cent) were over the age of 75.

To simply say 'these things happen, these are old frail vulnerable people, it's probably going to happen' is not really good enough."

One in seven of these deaths were considered 'premature', meaning they were potentially preventable.

The number of deaths from falls increased more than four-fold in a decade, from 1.2 deaths per 1,000 nursing home admissions in 2001 to 5.3 deaths per 1,000 admissions in 2011.

Premature Deaths In Nursing Homes, July 1, 2000 - June 30, 2013

  • Falls -- 2,679 deaths (81.5 percent)
  • Choking -- 261 deaths (7.9 percent)
  • Suicide -- 146 deaths (4.4 percent)
  • Complications of clinical care -- 39 deaths (1.2 percent)
  • Transport crashes -- 38 deaths (1.2 percent)
  • Assaults by other residents -- 34 deaths (1 percent)
  • Asphyxiation & aspiration -- 23 deaths (0.7 percent)
  • Poisoning -- 18 deaths (0.5 percent)
  • Drowning -- 15 deaths (0.5 percent)

Geriatrician Dr Catherine Yelland, the President of the Royal Australasian College of Physicians, was not involved in the research but told the Medical Journal of Australia the fact that these were deaths of elderly, frail people didn't mean they should be treated any less seriously.

"To simply say 'these things happen, these are old frail vulnerable people, it's probably going to happen' is not really good enough. It's not the way that we want people to die and it also indicates perhaps we don't care quite enough," she said.

"It may well be that in fact there's a pattern emerging, that the care we're giving people is not optimal, and they are at increased risk and that there needs to be closer attention to how to prevent these falls."

In addition to deaths from falls, a further 261 elderly nursing home residents choked to death over the study period, 15 drowned, 23 died of asphyxiation and 34 were assaulted by other nursing home residents. Thirty-nine people died as a result of 'complications of clinical care'.

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Four in five premature deaths in nursing homes are caused by falls.

The study authors have called for an Australia-wide policy framework to be introduced to help stop elderly Australians dying before their time.

"Our study should prompt action in policy, practice and research," the researchers wrote.

"National policy must act upon the evidence that premature deaths occur in nursing homes. Our data challenge the misperception that all deaths of frail, older persons with multiple comorbidities living in residential care are natural."

Nursing homes are chronically under-staffed in Australia, with a 2016 survey indicating just 8.2 per cent of staff report their facility is adequately staffed at all times.

Disturbingly, a single staff member is responsible for 38 nursing home residents on average.

"Current staff hours per resident per day are not adequate to meet care needs and that the current skills mix is compromising the quality of care given the rising levels of resident acuity," the survey results concluded.

Dr Yelland said the use of restraints in nursing homes -- meant to prevent falls and other injuries -- had actually caused a number of deaths.

AlexRaths
Dr Catherine Yelland wants more training for nursing home staff on how best to feed elderly patients. From 2000-2013, 261 nursing home residents died from choking.

"What used to be acceptable -- to have patients directly or indirectly restrained in chairs... the tray that was attached to the chair, the patients who were tied into chairs to stop them getting up -- we now know that sort of restraint is actually quite dangerous," she said.

"A general no restraint policy is safer for everyone."

The geriatrician also called for better staff training on how to feed elderly or frail patients to prevent choking, including swallowing assessments by speech pathologists.

"(Choking) is a very unpleasant way to die.

"We need to be training staff on how to feed the person who isn't able to feed themselves. We need to make texture-modified diets available and to just generally pay a little more attention to the nutrition issues of older people."

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