Residential aged care: the de facto hospice for New Zealand's older people

Australas J Ageing. 2014 Jun;33(2):114-20. doi: 10.1111/ajag.12010. Epub 2013 Mar 11.

Abstract

Aim: To describe short-term mortality among residential aged care (RAC) residents in Auckland, New Zealand.

Method: Prospective follow-up, 6828 residents (median age 86 years, 69.8% women) from census-type survey (10/9/2008); 152 facilities. Mortality data from central sources.

Results: Eight hundred and sixty-one (12.6%) died by 6 months. Survival related to RAC length of stay before the survey: those resident <1 month (subgroup, n = 380) having 80.0% survival, 1-6 months 83.2% and >6 months 87.4% (P < 0.0001). In those admitted to private hospital from acute hospital (n = 104 of the subgroup of 380), 6-month mortality was 36.5% (P < 0.0001 vs other 'short stayers'). Significant mortality predictors were: private hospital admission from acute hospital (hazard ratio (HR) = 2.02), unscheduled GP visit during the prior 2 weeks (HR = 1.90), personal care disability (HR = 1.90) and acute hospital admission number during the previous 2 years (≥3; HR = 5.40).

Conclusions: RAC mortality (especially post admission) is high. Training and resource in the sector should reflect this.

Keywords: home for older people; mortality; nursing home; older people; palliative care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging*
  • Censuses
  • Female
  • Health Care Surveys
  • Homes for the Aged / trends*
  • Hospice Care / trends*
  • Hospices / trends*
  • Humans
  • Kaplan-Meier Estimate
  • Length of Stay / trends
  • Male
  • Middle Aged
  • Mortality / trends*
  • New Zealand
  • Nursing Homes / trends*
  • Palliative Care / trends*
  • Patient Admission / trends
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Time Factors