{"id":21754,"date":"2025-04-23T11:00:00","date_gmt":"2025-04-23T15:00:00","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=news_release&#038;p=21754"},"modified":"2025-04-22T13:48:38","modified_gmt":"2025-04-22T17:48:38","slug":"severe-lasting-impairment-that-some-consider-worse-than-death-affects-many-residents-after-long-term-care-admission","status":"publish","type":"news_release","link":"https:\/\/www.ices.on.ca\/fr\/news-releases\/severe-lasting-impairment-that-some-consider-worse-than-death-affects-many-residents-after-long-term-care-admission\/","title":{"rendered":"Severe, lasting impairment that some consider \u2018worse than death\u2019 affects many residents after long-term care admission\u00a0"},"content":{"rendered":"<p><b><span data-contrast=\"none\">Ottawa, ON, April 23, 2025<\/span><\/b><span data-contrast=\"none\"> \u2013 <\/span><span data-contrast=\"auto\">20% of residents newly admitted to long-term care became permanently unable to make everyday decisions for themselves within five years, according to new research from <\/span><b><span data-contrast=\"none\">Bruy\u00e8re Health Research Institute <\/span><\/b><span data-contrast=\"auto\">and <\/span><b><span data-contrast=\"auto\">ICES<\/span><\/b><span data-contrast=\"auto\">.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">A significant number of long-term care (LTC) residents experience states of severe cognitive and physical impairment, leaving them unable to make personal decisions\u2014<\/span><span data-contrast=\"none\">like what to eat or what to wear\u2014<\/span><span data-contrast=\"auto\">and unable to communicate with staff or loved ones.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">\u201cOur study set out to trace the experiences of residents newly admitted to long-term care, and those who lived a year or more in a state of severe disability,\u201d says lead author Ramtin Hakimjavadi, Internal Medicine Resident at the University of Ottawa. \u201cWe should be talking more about what a meaningful, high-quality end of life looks like, given most older adults at this stage prioritize quality of life.\u201d\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">The study included <\/span><span data-contrast=\"none\">120,238 adults 65 and older who were newly admitted to LTC facilities in Ontario, Canada, between 2013 and 2018. Participants were followed until death, discharge from LTC, or April 1, 2023.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">Key Findings<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><b><span data-contrast=\"none\">20% of residents admitted to LTC<\/span><\/b><span data-contrast=\"none\"> became permanently unable to make everyday decisions for themselves, over the following five years and <\/span><b><span data-contrast=\"none\">half lived for more than 262 days<\/span><\/b><span data-contrast=\"none\"> with this level of disability.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><b><span data-contrast=\"auto\">13% of residents<\/span><\/b><span data-contrast=\"auto\"> admitted to LTC became <\/span><b><span data-contrast=\"auto\">totally dependent for all care<\/span><\/b><span data-contrast=\"auto\"> including bathing, toileting and eating over the study period. Half of these people lived for more than 45 days with this level of disability.\u00a0<\/span><span data-ccp-props=\"{&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Residents under 80 years old and those who had dementia were more likely to <\/span><b><span data-contrast=\"auto\">live longer once they reached total care dependence<\/span><\/b><span data-contrast=\"auto\"> and were unable to make any decisions for themselves.<\/span><span data-ccp-props=\"{&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">Residents with do-not-resuscitate or do-not-hospitalize orders <\/span><b><span data-contrast=\"auto\">did not live as long<\/span><\/b><span data-contrast=\"auto\"> after developing impairment or severe disabilities compared to residents without advance care directives.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"none\">\u201cIn interviews, long-term care residents have expressed that loss of independence is more distressing to them than the thought of dying. We are not offering resident-centered or evidence-based care if we don\u2019t talk about the possibility of severe disability and ask about the circumstances when life prolonging treatments would not be acceptable,\u201d says <\/span><span data-contrast=\"auto\">Hakimjavadi.<\/span><span data-ccp-props=\"{&quot;335559739&quot;:0}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">In this population of LTC residents, 65% had a Do-Not-Resuscitate (DNR) order and 25% had Do-Not-Hospitalize orders. These advance care directives reduced time spent living with severe disability, likely because the residents&rsquo; preferences were discussed, and care partners or providers knew how to support their end-of-life decisions. <\/span><span data-ccp-props=\"{&quot;335559739&quot;:0}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">\u201cResidents, their family members, and care teams should have open discussions about what quality of life means to the resident, considering the possibility of prolonged disability,\u201d says senior author Dr. Daniel Kobewka, an investigator at <\/span><span data-contrast=\"none\">Bruy\u00e8re Health Research Institute<\/span><span data-contrast=\"none\"> and adjunct scientist at ICES.\u00a0<\/span><span data-ccp-props=\"{&quot;335559739&quot;:0}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">\u201cPlanning ahead can help ensure that future care aligns with personal values, including the choice to prioritize comfort and dignity over life-prolonging interventions,\u201d adds Kobewka.<\/span><span data-ccp-props=\"{&quot;335559739&quot;:0}\"><\/p>\n<p><\/span><\/p>\n<p><b><span data-contrast=\"none\">ICES<\/span><\/b><span data-contrast=\"none\"> is an independent, not-for-profit research and analytics institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. ICES leads cutting-edge studies and analyses evaluating healthcare policy, delivery, and population outcomes. Our knowledge is highly regarded in Canada and abroad and is widely used by government, hospitals, planners, and practitioners to make decisions about healthcare delivery and to develop policy. For the latest ICES news, follow us on BlueSky and LinkedIn: @ICESOntario<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">The Bruy\u00e8re Health Research Institute<\/span><\/b><span data-contrast=\"none\"> conducts world-class research to maximize quality of life and shape the future health care. As part of an academic sciences centre, our research supports evidence-based care with a focus on aging and long-term care, palliative care, rehabilitation and recovery, and social accountability. To learn more, visit <\/span><a href=\"http:\/\/www.bruyere.org\/\"><span data-contrast=\"none\">http:\/\/www.bruyere.org<\/span><\/a><span data-contrast=\"none\">.\u00a0<\/span><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:276}\"><br \/>\n<\/span><b><span data-contrast=\"none\">FOR FURTHER INFORMATION PLEASE CONTACT:<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\"><br \/>\n<\/span><span data-contrast=\"none\">Misty Pratt<\/span><br \/>\n<span data-contrast=\"none\">Senior Communications Associate, ICES<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\"><br \/>\n<\/span><a href=\"mailto:Media@ices.on.ca\"><span data-contrast=\"none\">Media@ices.on.ca<\/span><\/a><br \/>\n<span data-contrast=\"none\">343-961-6982<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ottawa, ON, April 23, 2025 \u2013 20% of residents newly admitted to long-term care became permanently unable to make everyday decisions for themselves within five years, according to new research from Bruy\u00e8re Health Research Institute and ICES.\u00a0 A significant number of long-term care (LTC) residents experience states of severe cognitive and physical impairment, leaving them [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[32],"class_list":["post-21754","news_release","type-news_release","status-publish","hentry","topic-long-term-care-and-continuing-care"],"acf":{"infographic":[21763],"journal_article":[21753],"research_report":"","atlas":"","research_program":[6740],"site":[6734],"ices_scientist":"","announce_or_event":"","video":"","iitn_type":"Article","iitn_title":"","iitn_short_title":"","iitn_source_link_url":"","iitn_source_link_text":"","sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Severe, lasting impairment that some consider \u2018worse than death\u2019 affects many residents after long-term care admission\u00a0<\/title>\n<meta name=\"description\" content=\"Ottawa, ON, April 23, 2025 \u2013 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