Deaths of young people living in residential aged care: a national population-based descriptive epidemiological analysis of cases notified to Australian coroners

Risk factors associated with suicidal ideation in newly admitted working-age nursing home residents

INTRODUCTION

Suicide is a leading cause of mortality in the United States and recent initiatives have sought to increase monitoring of suicide risk within healthcare systems. Working-age adults (22-64 years) admitted to nursing homes may be at risk for suicidal ideation, yet little is known about this population.

METHODS

The national nursing home database, Minimum Dataset 3.0, was used to identify 323,436 working-age adults newly admitted to a nursing home in 2015. This cross-sectional study sought to describe sociodemographic and clinical characteristics, examine behavioral health treatment received, and determine resident characteristics associated with suicidal ideation at nursing home admission using logistic regression and reports adjusted odds ratios (aOR).

RESULTS

Suicidal ideation was present among 1.27% of newly admitted working-age residents. Almost 25% of those with suicidal ideation had no psychiatric diagnosis. Factors associated with increased odds of suicidal ideation included younger age (aOR 1.90), admission from the community (aOR 1.92) or a psychiatric hospital (aOR 2.38), cognitive impairments (aOR 1.46), pain (aOR 1.40), rejection of care (aOR 1.91), and psychiatric comorbidity (aOR depression: 1.91, anxiety disorder: 1.11, bipolar disorder: 1.62, schizophrenia: 1.32, post-traumatic stress disorder: 1.17).

LIMITATIONS

Due to the cross-sectional nature of this study, no causal inferences about suicidal ideation and the explored covariates can be made. The Minimum Dataset 3.0 has only one measure of suicidal ideation the Patient Health Questionnaire.

CONCLUSION

Factors other than psychiatric diagnosis may be important in identifying newly admitted working-age nursing home residents who require on-going suicide screening and specialized psychiatric care.

Injury prevention among young people in nursing homes: Recommendations following expert consultation forums

BACKGROUND

Approximately 6,000 people under the age of 65 years reside in nursing homes each year in Australia. These young people in nursing homes are at risk of premature death and preventable morbidity from injuries. Choking and falls are the leading causes of premature deaths in this cohort with reported rates of 44% and 33%, respectively.

OBJECTIVES

To develop injury prevention recommendations for young people in Australian nursing homes.

METHODS

This mixed-methods study comprised two expert consultation panels and a follow-up survey. Two expert and stakeholder consultation panels used a modified nominal group technique to formulate recommendations. A short survey was subsequently given to participants to validate responses from the panels and to provide an opportunity to evaluate and rank recommendations.

RESULTS

Ten recommendations were formulated for consideration that focused on system-wide reforms. Four were ranked as most important for implementation: education and training for nursing home staff; implementation of National Disability Insurance Scheme; support for coordinated care; and increasing residential housing stock that is appropriately designed.

CONCLUSION

Extensive changes are needed to prevent injury for young people in nursing homes. Implementation should reduce the risk of injury and lead to an improved quality of life for this cohort.

IMPLICATIONS FOR PRACTICE

This study provides an evidence base for aged care practitioners to improve practice within nursing homes to reduce fatal and non-fatal injuries for young people in nursing homes.