The admission of residents to long-term care homes can often result in severe disabilities within a short period. A recent study conducted by Bruyère Health Research Institute and ICES revealed that 20% of residents newly admitted to long-term care facilities became permanently unable to make everyday decisions for themselves within five years. This significant number of residents experienced cognitive and physical impairments that left them incapable of making personal decisions or communicating with others.
Lead author Ramtin Hakimjavadi, an Internal Medicine Resident at the University of Ottawa, emphasized the importance of discussing what a meaningful and high-quality end of life looks like for older adults in long-term care. The study, published in JAMA Network Open, followed 120,238 adults aged 65 and older who were admitted to LTC facilities in Ontario, Canada, between 2013 and 2018.
Key findings from the study include:
– 20% of residents admitted to LTC became permanently unable to make everyday decisions for themselves over the following five years.
– 13% of residents became totally dependent for all care, including bathing, toileting, and eating.
– Residents under 80 years old and those with dementia were more likely to live longer once they reached total care dependence.
– Residents with advance care directives, such as do-not-resuscitate or do-not-hospitalize orders, had different outcomes compared to those without.
Hakimjavadi stressed the importance of resident-centered and evidence-based care, highlighting the distress caused by the loss of independence in long-term care residents. Discussions about quality of life, preferences for care, and end-of-life decisions are crucial to ensuring that future care aligns with personal values.
Dr. Daniel Kobewka, the senior author of the study, emphasized the significance of open discussions between residents, their families, and care teams. Planning ahead and considering the possibility of prolonged disability can help ensure that care aligns with personal values and preferences for comfort and dignity over life-prolonging interventions.
The study, titled “Cognitive and Functional Decline Among Long-Term Care Residents,” provides valuable insights into the experiences of residents in long-term care facilities. It underscores the importance of proactive discussions about end-of-life care and the need for personalized, resident-centered approaches to ensure quality of life for residents in LTC settings.
