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Prediction of Mortality in Nursing Home Residents: Impact of Passive Self-Harm Behaviors

Published online by Cambridge University Press:  10 January 2005

Brian Draper ,
Henry Brodaty ,
Lee-Fay Low  and
Vicki Richards
Brian Draper
Affiliation:
Schools of Psychiatry, University of New South Wales, Sydney, Australia Public Health and Community Medicine, University of New South Wales, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia.
Henry Brodaty
Affiliation:
Schools of Psychiatry, University of New South Wales, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia.
Lee-Fay Low
Affiliation:
Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia.
Vicki Richards
Affiliation:
Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia.
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Abstract

Objective: The aim of this study was to determine whether indirect self-destructive behaviors predict mortality in nursing home residents. Method: This cross-sectional study with follow-up after 2 years and 3 months surveyed 593 residents in 10 nursing homes in the eastern suburbs of Sydney, Australia. The following instruments were used: Harmful Behaviors Scale (HBS), Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), Functional Assessment Staging Scale, Resident Classificatin Index, Cumulative Illness Rating Scale, Even Briefer Assessment Scales for Depression, and the suicide item from the Structured Hamilton Depression Rating Scale. Diagnoses of depression, dementia, and psychosis were obtained from nursing home records. Mortality data were obtained in August 1999. Results: At follow-up, 297 (50.1%) residents were still alive with a mean survival time of 565.4 days. Survival analyses found that mortality was predicted by older age, male gender, lower level of functioning, lower levels of behavioral disturbance on the BEHAVE-AD, and higher scores on the HBS “passive self-harm” factor-based subscale, which includes refusal to eat, drink, or take medication. Discussion: These results suggest that passive self-harm behaviors predict mortality in nursing home residents.

Keywords

Mortalityindirect self-destructive behaviornursing home
Type
Articles
Information
International Psychogeriatrics , Volume 15 , Issue 2 , June 2003 , pp. 187 - 196
Copyright
© 2003 International Psychogeriatric Association

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