Identification of the trajectory of functional decline for advance care planning in a nursing home population

Objective To identify diagnostic groups and the form of the trajectory of functional decline that has the potential to enhance advance care planning (ACP) in a nursing home (NH) population. Methods Retrospective, longitudinal study with dependent variable (function) derived from the Resident Classif...

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Bibliographic Details
Published in:Australasian journal on ageing 2017-09, Vol.36 (3), p.E14-E20
Main Authors: Lawrence, Suanne, Robinson, Andrew, Eagar, Kathy
Format: Article
Language:English
Subjects:
Activities of Daily Living
Advance Care Planning
Age Factors
Aged, 80 and over
Aging
Cause of Death
Decision Support Techniques
Disease Progression
end‐of‐life care
Female
Frail Elderly
Frailty - diagnosis
Frailty - mortality
Frailty - therapy
Geriatric Assessment
Health Status Indicators
Homes for the Aged
Humans
Linear Models
Longitudinal Studies
Male
Neoplasms - diagnosis
Neoplasms - mortality
Neoplasms - therapy
Nursing Homes
Retrospective Studies
Tasmania
Time Factors
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Summary:Objective To identify diagnostic groups and the form of the trajectory of functional decline that has the potential to enhance advance care planning (ACP) in a nursing home (NH) population. Methods Retrospective, longitudinal study with dependent variable (function) derived from the Resident Classification Scale (RCS), 1997–2008. Trajectory modelling used linear and curvilinear terms. Results The organ failure or other residents have a linear average functional decline. The organ failure residents had an average decline of 6.5 points per year and average function score at death of 68.6, CI [62.4, 74.8]. The cancer and frailty residents had significant curvilinear terms. The frailty residents had a slower rate of decline at 9.54 points per year and were most care dependent at death, with an average function score of 77.1, CI [73.8, 80.9]. Conclusion Functional change is a measurable variable for a predictive tool to enhance ACP for NH residents based on their diagnosis.
ISSN:1440-6381
1741-6612
DOI:10.1111/ajag.12454