Exploring Factors Behind Premature Deaths in Nursing Homes

The transition to a nursing home is a significant life change, often marked by both physical and emotional adjustments. In recent years, concerns have arisen regarding the unfortunate reality of individuals experiencing a decline in health and passing away shortly after entering nursing care facilities. This phenomenon has prompted scrutiny and calls for a deeper understanding of the factors contributing to premature deaths in nursing homes.[1]

Health Status at Admission:
One crucial aspect influencing the mortality rates in nursing homes is the health condition of residents upon admission. Many individuals enter these facilities during advanced stages of illness or with complex medical needs. The severity of pre-existing health conditions[2] can impact life expectancy, and individuals may succumb to their illnesses despite the best efforts of the caregiving staff.

Frailty and Vulnerability:
Nursing home residents often contend with frailty and increased vulnerability due to age-related issues or chronic illnesses. Frail individuals may have compromised immune systems, making them more susceptible to infections. The close living quarters and communal nature of nursing homes can facilitate the rapid spread of illnesses, further exacerbating health challenges.[3]

Social Isolation:
The transition to a nursing home can sometimes lead to feelings of social isolation and loneliness, which have been linked to adverse health outcomes. Studies suggest that individuals lacking social engagement may be at a higher risk of physical and mental health issues.[4] The emotional toll of isolation, coupled with a sense of unfamiliarity in a new environment, can impact overall well-being and potentially contribute to a decline in health.

Quality of Care:
The quality of care provided in nursing homes plays a pivotal role in residents’ health outcomes. Facilities with insufficient staffing, inadequate training, or a lack of resources may struggle to meet the complex needs of their residents.[5] Neglect or substandard care can result in medical complications and contribute to premature mortality.

Underlying Mental Health Issues:
Mental health issues, including depression and anxiety, are prevalent among elderly individuals, and they can be exacerbated by the transition to a nursing home. Untreated or undetected mental health conditions can have a profound impact on physical health, potentially leading to a faster decline.[6]

Palliative Care and End-of-Life Decisions:
In some cases, individuals enter nursing homes with advanced illnesses, and their choice may be influenced by a desire for specialized palliative care. Residents and their families may opt for comfort-focused care rather than aggressive medical interventions, influencing the trajectory towards end-of-life decisions.[7]

Conclusion:
The factors contributing to premature deaths in nursing homes are multifaceted and often interconnected. Understanding this complex landscape requires a holistic approach that considers the health status at admission, the vulnerability of residents, the quality of care provided, social and emotional well-being, and the prevalence of end-of-life decisions. Addressing these challenges demands a collective effort from healthcare professionals, families, and policymakers to ensure that nursing home residents receive the support, care, and dignity they deserve in their final chapters of life.

What You Can Do:
Regardless of whether you work directly with older adults, familiarizing yourself with their care can be a noble and enriching step in your career.

Explore opportunities to learn the fundamentals of caring for older adults. If you encounter challenges in finding suitable courses that align with your needs and learning preferences, we’re here to assist you. Reach out, and let’s discuss how we can best support your professional growth.

Thank you for your dedication and commitment to making a difference.

[1] Braggion, Marco, et al. “Overall mortality and causes of death in newly admitted nursing home residents.” Aging Clinical and Experimental Research 32 (2020): 275-280.

[2] Ferrah, Noha, et al. “Death following recent admission into nursing home from community living: a systematic review into the transition process.” Journal of aging and health 30.4 (2018): 584-604.

[3] Møgelmose, Signe, et al. “Exploring the impact of population ageing on the spread of emerging respiratory infections and the associated burden of mortality.” BMC Infectious Diseases 23.1 (2023): 767.

[4] Dugdale, Lydia S., et al. “Ethical Guidance on Family Caregiving, Support, and Visitation in Hospitals and Residential Health Care Facilities, Including During Public Health Emergencies: an American College of Physicians Position Paper.” Journal of General Internal Medicine 38.8 (2023): 1986-1993.

[5] Hitchen, Tatiana, et al. “Premature and preventable deaths in frail, older people: a new perspective.” Ageing & Society 37.8 (2017): 1531-1542.

[6] Lind, Lisa. “Meeting the Behavioral Health Needs of LTC Residents: Lessons Learned From the Pandemic.” Caring for the Ages 24.3 (2023): 16.

[7] Bern-Klug, Mercedes, ed. Transforming palliative care in nursing homes: The social work role. Columbia University Press, 2010.