Old People Die Alarmingly Quickly in Nursing Homes, Study Finds

Categories: Health
methuselah.jpg
The Bible claims Methuselah lived to be 969. No word on how long he lasted after entering a nursing home.
If you're going to put Grandma or Grandpa in a nursing home -- don't put off making a visit. That's the upshot of a U.C. San Francisco study published this week, which reveals elders often don't last very long in care facilities.

Of its sample of nursing home patients who died between 1992 and 2006, a full 80 percent were dead within one year, claims the study, which appears in the current edition of the Journal of the American Geriatrics Society.  The paper also determined that death, like life, ain't fair: Men die faster than women; and married people die quicker than single ones. Counter-intuitively, however, richer people die faster than poorer ones.

Lead author Anne Kelly, a social worker at the San Francisco VA Medical Center, has an explanation for this. And it has nothing to do with divine comeuppance.

Simply put, folks with more money had the resources to stay at home or elsewhere longer and exhaust all the possibilities before ending up at a nursing home, she says. By the time they reach the last stage, they're further along than poor folks.

The study was based on analysis of 1,817 nursing home residents who died over a 17-year span in nursing homes; fully one-quarter of Americans now die in nursing homes, the researchers note. The average age of study participants when they moved to nursing homes was just over 83. And the average length of stay before death was just under 14 months. The median stay, however, was just five months -- and 53 percent of the nursing home residents in the study pool had died within six months.

Granted, the study pool was only composed of patients who were already dead -- so elderly people who lived, or continue to live, for marathon stretches in nursing homes were not included. But researchers' conclusions are as stark as yours likely are: Patients often don't last long. Those with elderly relatives should keep that in mind -- as should health professionals.

"We need to engage nursing home residents in planning conversations about end-of-life care and treatment preferences very soon after they are admitted," said co-author Dr. Alex Smith, a UCSF professor . "We have only a brief amount of time to address their concerns before they become seriously ill."

This story has been edited since its publication.

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1 comments
ruthheule
ruthheule

I'm not surprised by this.  I have worked in LTC for 24 years.  The trend is that people do not come into nursing homes until they are very ill.  Nursing homes are not like they used to be "back in the day" when people went there to retire.  Now they go to ALF  (Assisted Living Facility) first because it is less expensive and they don't meet the criteria to stay in a nursing home.  (You must require assistance of at least 2 ADL's to qualify)  They live out their "better" years either at home (there are grants available to people even on medicaid to make this possible because it is cheaper than living in LTC)  or in ALF.  The ALF I know of keep their residents far too long and past their ability to properly care for them.  (in other words, they should have been discharged from those places long before they do because they are providing care outside their scope.) By the time we see them at the nursing home they are very ill and most of the time in their "last days."  And just because someone has the money to stay at home doesn't mean they are getting "good care" while they are there.  Once again, by the time medical care is sought out for them they are very ill.  So after watching all this take place, I think that these same people would have died whether they were still at home or in an ALF.  They are usually very compromised when they come to the LTC with no plans to discharge.  That's my take on it after 24 years of experience seeing tremendous changes in the clientele that have come to LTC.


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