SHOCKING new figures show a 400 per cent increase in the number of premature and potentially preventable deaths in Australian nursing homes over the past decade, leading to a call for a national prevention strategy.
The deaths, from falls, choking, suicide and homicide, account for almost 3330 of the reported 21,672 deaths of residents in a 13-year period.
About four out of five of these premature and preventable deaths were from falls (81.5 per cent) while one in 12 people (7.9 per cent ) died from choking, and one in 18 (4.4 per cent) died by resident to resident assault or from suicide.
Only 1.2 per cent died from the results of clinical care.
Led by Joseph Ibrahim from the Monash University Faculty of Medicine, Nursing and Health Sciences, the study used coronial data to review the deaths by external causes of all nursing home residents between 2000 and 2013.
It found the 400 per cent increase over the period was in part due to better reporting.
However, Professor Ibrahim cautioned this figure is probably an underestimate, with some deaths being misclassified as “natural” due to the tendency of health professionals and society to “downplay” the significance of injury-related factors, tending to assume old age and any underlying illness as the explanation for deaths.
“Currently no one entity is responsible for reducing harm by improving practice,” Professor Ibrahim said. “Improving the quality of care for nursing home residents requires a better understanding of how, why, where and when they die.
“With this study we have our first real understanding of how many deaths are occurring in nursing homes that shouldn’t be happening.
“Professionals from governments and the nursing home sector should develop strategies for preventing these deaths and establish a lead authority, responsible for reducing harm by improving practice.”
Professor Ibrahim acknowledged that the increased number of preventable deaths may, in part, be due to increased scrutiny of aged care facilities.
Right to self-determination
VICTORIAN aged care provider Benetas chief executive Sandra Hills said consideration needed to be given to a person’s right to self-determination when it came to falls risk.
“While we need to ensure our residential aged care environments are as safe as possible for residents, we need to consider how a black-and-white focus on falls prevention might compromise an older person’s quality of life,” Ms Hills said. “We often work with residents, families and their medical and allied health teams to identify how we can best support them to have a happy life; for some this might mean walking unassisted or not wearing devices intended to prevent harm.”
However, Ellis Blaikie from the Combined Pensioners and Superannuants Association said the fact that more than 80 per cent of premature deaths were related to falls was “shocking”. “There’s a lot of talk about the rights of residents to take risks, but what about the rights of residents to have their care needs met in a way that doesn’t require them to take a risk that may lead to significant pain and suffering,” Ms Blaikie said.
“Falls are not a sign that a home respects the autonomy of residents and their right to take risks; it’s a sign that there aren’t enough staff on duty to meet the needs of residents.
“Nursing homes must have enough staff on duty to help residents with their daily needs so you don’t have residents trying to toilet themselves because they can’t wait any longer.
“What we need is an aged care system that can take these premature deaths, understand what’s gone wrong and put in place solutions at a national level to make sure it doesn’t happen again.”
