Facility closures, relocation mean higher death rates for frail seniors — study
30 per cent mortality rate for former residents of Kelowna care home closed by Liberals
Research commissioned by B.C.’s largest health care union suggests that death rates among frail elderly nursing home residents relocated as a result of facility closures will be two to four times higher than if they weren’t moved. And to underline those conclusions, the Hospital Employees’ Union (CUPE) revealed today that nearly 30 per cent of the residents of a Kelowna long-term care home closed earlier this year have died.
Kingston, Ontario-based researcher Victoria Robinson surveyed four decades of studies on the impact of relocation among frail elderly patients and nursing home residents. She found that the negative physical and psychological effects of transfers include depression, increased irritability, serious illness and even death.
“Patient relocation studies indicate that those transferred are 1.99 to 3.76 times more likely to die than those not transferred,” says Robinson. “Those results can be generalized to the frail elderly in nursing homes. In fact, the research suggests mortality rates may be even higher for this group.” HEU secretary-business manager Chris Allnutt says that the Gordon Campbell Liberals’ radical makeover of seniors’ care has already resulted in a significant number of forced relocations. “But I doubt that politicians and health bureaucrats considered the full human impact of these transfers before hatching their seniors’ care scheme.”
A dramatic example of this impact is in the Okanagan where HEU members have tracked the health and welfare of the 24 residents who called Kelowna’s May Bennett care facility home before notice of closure was issued on September 27, 2001 — exactly one year ago tomorrow.
At least seven of those residents — nearly 30 per cent — have since died. One passed away the night the closure was announced, the remaining six after they left May Bennett. The last resident left the facility on January 28.
“Sometimes resident moves are unavoidable and take place because a senior’s health needs have become more acute or to be closer to family,” says Allnutt.
“But let’s be clear. Thousands of frail elderly British Columbians have already been or will be unnecessarily relocated as a result of this government’s restructuring of seniors’ care.“All planned nursing home closures should be put on hold until the real impact of these forced moves on seniors can be assessed by the appropriate authorities,” adds Allnutt.
Relocation Stress Syndrome is a recognized nursing diagnosis in the United States. The elevated mortality risk inherent in the transfer of frail elderly has resulted in federal and state legislation designed to protect nursing home residents south of the border. There is no similar acknowledgement of the condition in Canada.
Robinson is a population health researcher with a graduate degree in Community Health and Epidemiology from Queen’s University. In the review prepared for HEU, Robinson surveyed more than two dozen peer-reviewed studies related to relocation stress. She’s also conducted original research on this topic. Robinson found that:
- Relocation can have negative physical and psychological effects on patients in acute care and residents of long term care. These effects are more pronounced in elderly populations, particularly frail elderly patients and long term care residents;
- Acute care patients and long term care residents are at an elevated mortality risk when they are relocated. Studies examining the effect of transferring (relocating) different patients groups between institutions have found that transferred patients were at an elevated mortality risk between 1.99 and 3.76 times greater than those patients who were not transferred;
- Contradictory studies that have not found an increased mortality risk for transferred patients often have methodological problems. Some of the methodological concerns include small sample sizes, inadequate statistical power and a lack of control groups;
- Based on 40 years of documentation and observation, Relocation Stress Syndrome was recognized as an official Nursing diagnosis in 1992 and was defined as the physiologic and psychosocial disturbances that result from transfer from one environment to another; and
- According to the U.S government’s Administration on Aging, Transfer Trauma, as a result of sudden and unexpected relocation, is associated with depression, increased irritability, serious illness and elevated mortality risk for the frail elderly.
Click here for a pdf version of Robinson’s review HEU Literature Review — Sept. 23
Click here for a Microsoft Word version of Robinson’s review HEU Literature Review — Sept. 23