Assessments Could Reduce End-of-Life Hospital Stays for Seniors

A study published in the Journal of the American Medical Directors Association found better application of standard assessment tools could help long-term care communities identify new residents at risk of hospitalization or death in the first 90 days of admission, reports Medical Xpress . The researchers analyzed data from 143,067 residents 65 or older admitted to long-term care communities in Ontario, Alberta, and British Columbia, from 2010 to 2016. More than 15 percent of residents had a history of heart failure and were more likely to be hospitalized and twice as likely to have higher mortality rates than those without. One year after admission, residents with a history of heart failure had a mortality rate more than 10 percent higher. The study concluded that newly admitted residents' history of heart failure, and their scores on the interRAI Changes to Health, End-Stage disease, Signs, and Symptoms (CHESS) scale, can accurately evaluate those most at risk. Residents with high CHESS scores, even with no heart failure history, were more likely to die when hospitalized. Mortality rates for those with the highest scores were 80 percent, and most of these individuals died while hospitalized. "These two factors independently identified this increased risk," says University of Waterloo Professor George Heckman. "By making clinical assessments early, advance care planning discussions can take place."