Medindia
Advertisement

Assessments could Cut End-of-life Hospital Stays for Elderly: Study

by Iswarya on January 9, 2019 at 2:18 PM
Font : A-A+

Assessments could Cut End-of-life Hospital Stays for Elderly: Study

Using better and standard assessment tools can help long-term care homes recognize which new patients are at-risk of hospitalization or death in the initial 90 days of admission, reports a new study. The findings of the study are published in the Journal of the American Medical Directors Association.

A study from the University of Waterloo and Schlegel-UW Research Institute for Aging has found that newly admitted residents' history of heart failure, as well as their score on the interRAI Changes to Health, End-Stage disease, Signs, and Symptoms (CHESS) scale, can accurately determine which residents are most at risk.

Advertisement


"Being able to identify at-risk residents early can help long-term care homes ensure they have the necessary care and management strategies in place," said George Heckman, associate professor in the School of Public Health and Health Systems at Waterloo and Schlegel Research Chair in Geriatric Medicine. "These assessments can also help health providers determine which conditions require a trip to the hospital or which would be better managed as a hospice-type condition within the homes themselves."

He added, "It is not always advisable to take someone who is closing in on the end of life out of their home and put them into a hospital setting. These residents are very complex and frail, and not only might they not benefit from the hospital visit, but the transition itself can also lead to harms such as delirium and further disability."
Advertisement

The study examined data collected from 143,067 residents aged 65 years or older, admitted to long-term care homes in Ontario, Alberta and British Columbia, between 2010 and 2016.

It found that over 15 percent of residents had a history of heart failure. Residents with heart failure were more likely to be hospitalized than those without (18.9 percent versus 11.7 percent). Residents with a history of heart failure were also twice as likely to have higher mortality rates than those without, 14.4 percent versus 7.6 percent. At the one-year mark, residents with a history of heart failure had a mortality rate of more than 10 percent higher, at 28.3 percent compared to 17.3 percent.

The CHESS scale identifies frailty and health instability and is embedded within the MDS, an interRAI instrument mandated in almost all long-term care homes across Canada. Higher health instability, identified through higher CHESS scores, were associated with a greater risk of hospitalization and death at three months. Most notably, residents with high CHESS scores were more likely to die even when sent to the hospital, regardless of whether they had heart failure or not. Mortality rates for the highest CHESS scores were 80 percent; most of these residents died in hospital.

"Together, these two factors independently identified this increased risk," Heckman said. "By making clinical assessments early, advance care planning discussions can take place. Furthermore, by ensuring that the entire long-term care home care team, including personal support workers, understand these risks, they can help monitor resident health and optimize their quality of life in the long-term care home."

Source: Eurekalert
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
News Category
What's New on Medindia
Gonorrhea
World Alzheimer's Day 2021 - 'Know Dementia, Know Alzheimer's
'Hybrid Immunity' may Help Elude COVID-19 Pandemic
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.


Recommended Reading
Oral Care Tips for Aging Teeth
Good oral hygiene is the to healthy teeth during old age. Correct brushing techniques and regular .....
Directing the Course to Healthy Aging
An understanding of the rise in the aging population over the years and the need for attention to .....
Eat Right and Beat Those Wrinkles - Foods that Cause Aging
Bad eating habits will affect your health as well as your skin and make you look older than your ......
Life without Death and Aging by 2045
Do you want to live forever? No one likes death, and everyone wants to stay young. Two genetic ......

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use