Long-term care residents face severe disabilities that leave them unable to make everyday decisions for themselves, according to a new study by Bruyère Health Research Institute and ICES. The research, published in JAMA Network Open, followed 120,238 adults aged 65 and older who were newly admitted to LTC facilities in Ontario, Canada, between 2013 and 2018.
The findings revealed that 20% of residents admitted to LTC became permanently unable to make personal decisions within five years, with half of them living for more than 262 days in this state. Additionally, 13% of residents became totally dependent on care for activities like bathing, toileting, and eating, with half of them living for more than 45 days in this condition.
Residents under 80 years old and those with dementia were more likely to live longer once they reached total care dependence. Interestingly, residents with advance care directives, such as do-not-resuscitate or do-not-hospitalize orders, did not live as long after developing impairments compared to those without these directives.
Lead author Ramtin Hakimjavadi emphasized the importance of discussing quality of life and preferences with residents, their families, and care teams. By planning ahead and aligning future care with personal values, including prioritizing comfort and dignity over life-prolonging interventions, individuals can ensure their end-of-life decisions are respected.
The study highlights the need for resident-centered care that considers the possibility of severe disability in LTC settings. Open discussions about quality of life and preferences can help improve the overall well-being of residents and ensure their end-of-life wishes are respected.
For more information, the study “Cognitive and Functional Decline Among Long-Term Care Residents” can be accessed in JAMA Network Open. This research sheds light on the challenges faced by LTC residents and the importance of personalized care that respects individual preferences and values.
