A comprehensive study analysing the number of deaths in Australian care homes has found a more than 400% increase in the number of premature or preventable deaths over the last decade.
The main causes noted included falls, choking, suicide and homicide, which account for almost 3,300 deaths throughout the period studied.
Unintentional and intentional causes
The study was conducted by the Monash University Faculty of Medicine, Nursing and Health Sciences, which used coronial data to look into the number and types of deaths that have occurred in nursing homes between 2000 and 2013.
Researchers discovered that of the 21,672 deaths of care home residents reported, 3,289 (15.2%) were due to external or preventable causes, of which almost all were unintentional.
The most common unintentional cause was death from a fall (81.5%), with choking being another notable factor at 7.9%.
For intentional causes, 4.4% were due to a result of suicide, and a 1% was attributed to resident-to-resident assault.
Rise in reports
While the huge increase in premature deaths is worrying, many have pointed out that the rise is partly due to the existence of a better system to report incidents than what had existed previously.
“We have uncovered a ‘systems’ problem, rather than a problem with a few bad nursing homes or individuals,” said Professor Joseph Ibrahim from the Department of Forensic Medicine at Monash University, who led the study into the premature deaths.
He also stated in the past, the number of premature deaths was most likely underestimated due to deaths often being misclassified as ‘natural’.
This was a result of many health professionals, as a well as a society as a whole, downplaying injuries as viable factors in death when it was typically believed that old age and previous underlying illnesses were the explanation in most cases.
Professor Ibrahim has since called for a national strategy to reduce the number of unnecessary deaths in the care sector, including in home care.
“Professionals from governments and the nursing home sector should develop strategies for preventing these deaths and establish a lead authority, responsible for reducing harm by improving practice in nursing homes,” he said.
“Improving the quality of care for nursing home residents requires a better understanding of how, why, where and when they die. The global population is aging rapidly, and the need for aged care services is consequently increasing.”
Choice vs quality of life
But some people have said potential harm to care home residents is always a possibility if you wish to provide a good quality of life.
Head of the aged care provider organisation Leading Age Services Australia, Sean Rooney, praised Professor Ibrahim’s study, saying it offered “some interesting insights.”
But while Mr Rooney explained the care industry is always seeking to maintain and improve its standards of care, he says there is always a level of risk involved:
“A good quality of life requires a certain degree of autonomy so residents may make choices that enhance their quality of life, choices that may also increase the risk of potential harm.”