Predicting Death in the Nursing Home: Development and Validation of the 6-Month Minimum Data Set Mortality Risk Index

Porock, Davina; Oliver, Debra Parker; Zweig, Steve; Rantz, Marilyn; Mehr, David R.; Madsen, Richard; Petroski, Greg

doi:10.1093/gerona/60.4.491

Cited by 103 publications

(79 citation statements)

References 19 publications

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“…However, all available mortality prediction models have been developed using data from a single study, but all from the United States and Western Europe (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), which greatly limits their validity for use even in other high-income countries, let alone in the developing countries. For instance, a model developed using data from the Health and Retirement Study (HRS) in the United States showed poor performance when it was applied to older adults in England (18).…”

mentioning

confidence: 99%

Development and Validation of a 10-Year Mortality Prediction Model: Meta-Analysis of Individual Participant Data From Five Cohorts of Older Adults in Developed and Developing Countries

Suemoto

Ueda

Beltrán‐Sánchez³

et al. 2016

The Journals of Gerontology: Series A

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mentioning

confidence: 99%

Development and Validation of a 10-Year Mortality Prediction Model: Meta-Analysis of Individual Participant Data From Five Cohorts of Older Adults in Developed and Developing Countries

Suemoto

Ueda

Beltrán‐Sánchez³

et al. 2016

The Journals of Gerontology: Series A

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“…Predicting when residents are likely to require end of life care features in current literature on dying and has been suggested to be useful in improving the identification of dying and the initiation of specialist palliative care service provision (Grbich, Maddocks, Parker, Brown, Willis, Hofmeyer, & Piller, 2005;Mitchell, Kiely, Hamel, Park, Morris & Fries, 2004;Porock, Oliver, Zweig, Rantz, Mehr, Madsen & Petroski, 2005;Wright, Zhang, Ray, Mack, Trice, Balboni, Mitchell, Jackson, Block, Maciejewski & Prigerson, 2008). Predicting when a resident has entered a dying phase in a non malignant disease can be challenging (Miller, Teno & Mor, 2004).…”

Section: Predicting the Dying Phase In Non Malignant Diseasesmentioning

confidence: 99%

“…Predicting when a resident has entered a dying phase in a non malignant disease can be challenging (Miller, Teno & Mor, 2004). In a study of six month survival rates in nursing home residents, Porock et al (2005) calculated the risk of death using a minimum data set with a range of variables, such as gender, age, cancer, congestive heart failure, shortness of breath, treatments and activities of daily living. The purpose of the study was to identify those indicators that best predicted six month mortality and to identify those residents "who may benefit from specialist palliative care or hospice services" (p. 497).…”

Section: Predicting the Dying Phase In Non Malignant Diseasesmentioning

confidence: 99%

Dying in a rural residential aged care facility: An action research and reflection project to improve end‐of‐life care to residents with a non‐malignant disease

Rowley

Taylor

2011

Int J of Nursing Practice

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Rowley, J 2010, 'Dying in a rural residential aged care facility: an action research and reflection project to improve end of life care to residents with a non-malignant disease ', PhD thesis, Southern Cross University, Lismore, NSW. THESIS DECLARATIONI certify that the work presented in this thesis is, to the best of my knowledge and belief, original, expect as acknowledged in the text, and the material has not been submitted, either in whole or in part, for a degree at this or any other University. Special thanks, is reserved for my husband Greg, whose loving, extensive support helped me to achieve completion. In addition, to our children Dylan and Amber, who lovingly supported me throughout this journey.This thesis is dedicated to the memory of my father, Donald Raymond Riley.iii ABSTRACT This qualitative research explored end of life care provided to people dying with a non malignant disease in two Australian rural, residential aged care facilities.Residential aged care facilities provide end of life care for many people dying from non malignant diseases. The illness trajectory in non malignant diseases can be difficult to predict and symptom management can be challenging.Further, as the Australian population ages, the demand for optimal end of life care for frail, older people is anticipated to increase. Therefore, this study aimed to explore issues as identified by nurses and relatives of residents dying from a non malignant disease in order to examine ways in which nurses can provide nursing care that maximises the likelihood of a good death, identify the barriers nurses perceive to prevent optimal end of life care to dying residents, and explore the relationships between nurses and relatives of the dying resident, with the intention of improving care.Following ethical clearance, 14 aged care staff overall within both facilities were recruited to the project. Participants included Registered Nurses, Enrolled Nurses, Assistants in Nursing and other aged care staff personnel, all of whom were in a carer relationship with a dying resident. In addition, eight relatives of dying residents were interviewed, using individual, face to face, semi structured interviews.Taylor's (2006) 13 step action research and reflection method was incorporated into five main phases, including foundation building, reflection on practice iv stories, identifying thematic concerns, action plan creation, implementation and critical reflection. In both facilities, group meetings were held weekly for up to 19 weeks. Data were gathered using combinations of reflective drawing, practice stories, interviews and surveys.Relatives' interview transcripts were incorporated into the nurses' group meetings, so that end of life care issues of importance to relatives were shared, with the intention of assisting the nurses to examine the nature of aged care nursing and relationships that occur with relatives of the dying resident. This project demonstrated that it is possible to establish a working relationship with aged care nurses, with no prio...

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“…Existing models with high validity for predicting death among nursing home residents (greater than 70 percent accuracy in predicting likelihood of death in six months) have used MDS items such as diagnoses, shortness of breath, weight loss, dehydration, poor appetite, deterioration in condition, and increased number of activities of daily living requiring help. 16 Automatic eligibility is an improvement for several reasons. The six-month prognosis requirement for eligibility may limit access to hospice, particularly for the majority of nursing home residents who have terminal conditions with a less predictable life trajectory than cancer.…”

Section: Who Uses Nursing Home Hospice Services?mentioning

confidence: 99%

A New Medicare End-Of-Life Benefit For Nursing Home Residents

et al. 2010

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Many elderly people spend their final days in nursing homes. For them, high-quality end-of-life care is an important component of their overall care. Unfortunately, the Medicare hospice benefit-the primary source of palliative care coverage for Medicare beneficiaries-is a poor fit with the nursing home setting. We recommend creating a separate end-of-life Medicare benefit for nursing home residents based on documented need for services that neither requires physicians to certify a person's prognosis, nor requires beneficiaries to choose it or to agree to forgo curative care. Nursing homes would be paid directly for end-of-life care services and held accountable for their quality.

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Predicting Death in the Nursing Home: Development and Validation of the 6-Month Minimum Data Set Mortality Risk Index

Abstract: A reasonably accurate, validated model has been produced, with clinical application through a scored point system, to assist clinicians, residents, and family members in defining good goals of care around end-of-life care.

Cited by 103 publications

References 19 publications

Development and Validation of a 10-Year Mortality Prediction Model: Meta-Analysis of Individual Participant Data From Five Cohorts of Older Adults in Developed and Developing Countries

Development and Validation of a 10-Year Mortality Prediction Model: Meta-Analysis of Individual Participant Data From Five Cohorts of Older Adults in Developed and Developing Countries

Dying in a rural residential aged care facility: An action research and reflection project to improve end‐of‐life care to residents with a non‐malignant disease

A New Medicare End-Of-Life Benefit For Nursing Home Residents

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