Nature and extent of external-cause deaths of nursing home residents in Victoria, Australia

Objectives To describe the nature and extent of external-cause deaths of residents of nursing homes in Victoria, Australia. Design A retrospective cohort study of all decedents using routinely collected data contained within the National Coronial Information System. Setting Accredited nursing homes in Victoria. Participants Nursing home residents who had died from external causes and whose deaths were reported to the Coroners Court between July 1, 2000, and December 31, 2012. Measurements Basic descriptive analysis was conducted to measure frequencies and proportion of exposures within each outcome group, and rates were calculated using population data. Results One thousand two hundred ninety-six external cause deaths of nursing home residents were identified. Deaths were due to falls (n = 1,155, 89.1 ), choking (n = 89, 6.9 ), suicide (n = 17, 1.3 ), complications of clinical care (n = 8, 0.6 ) and resident-on-resident assault (n = 7, 0.5 ). Deaths occurred more frequently in women (n = 814, 62.8 ), in keeping with the sex distribution in nursing homes, and residents aged 85 and older (n = 923, 71.2 ). The number of inquests held to investigate a death as a matter of public interest was small (n = 24, 1.9 ). Conclusion A significant proportion of nursing home resident deaths are from external causes and are potentially preventable. A shift in community attitudes is required toward an understanding that premature death of a resident from injury is not a natural part of life