Severe impairment often presents near the end of life for long-term care residents
By Lori Solomon HealthDay Reporter
THURSDAY, May 1, 2025 (HealthDay News) — Development of severe permanent cognitive or functional impairment is common among residents admitted to long-term care (LTC), according to a study published online April 23 in JAMA Network Open.
Ramtin Hakimjavadi, M.D., from the University of Ottawa in Ontario, Canada, and colleagues assessed the incidence of severe cognitive and functional impairment among people admitted to LTC, as well as life expectancy after impairment. The analysis included administrative health data from 120,238 older adults admitted to LTC facilities between April 1, 2013, and March 31, 2018, and followed until death, discharge, or April 1, 2023.
The researchers found that during the study period, 20.0 percent of at-risk residents had become permanently unable to make decisions, 7.7 percent had become permanently unable to communicate, 13.4 percent developed total care dependence, and 32.8 percent developed incontinence of stool or urine. The shortest median survival time was seen for residents who entered a state of total care dependence (45 days), and the longest median survival was seen for those with newly developed incontinence of stool or urine (356 days). Longer median survival after entering a state of severe impairment was seen for younger residents (median survival after developing total care dependence: 133 days for those younger than 80 years versus 30 days for those aged 80 years and older) and those with dementia at admission (median survival after developing the inability to make decisions: 318 days with dementia versus 74 days without dementia).
“These results suggest that building shared understanding and open communication about the natural course of frailty trajectories for LTC residents may support resident-centered medical decision-making,” the authors write.
One author disclosed being a cofounder of CANImmunize Inc.
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