Kaiser
Investigation Finds Residents in Long-Term Care Facilities
Quietly Killing Themselves
A six-month investigation by Kaiser Health News recently found that elder adults residing in long-term care facilities are overlooked as the numbers of suicides in the U.S. continue to climb.
The study used the case of a resident in a Wisconsin nursing home to illustrate their finding. The resident was a 77-year-old man, a former machinist whose wife of 51 years had just passed away and who had just been diagnosed with stage 4 throat cancer, and was admitted into a nursing home in late 2017. His children thought that he would only be in the nursing home for about two weeks and then he would return home to begin chemotherapy. That was not what happened. Two days after Christmas, while the resident was alone in his room, he killed himself and did not leave any kind of note. The official cause of death was listed as asphyxiation.
According to the investigation, poor documentation makes it hard to determine how often these deaths occur in long-term care facilities. However, new data that was analyzed suggested that there are “hundreds of suicides by older adults each year—nearly one per day—related to long-term care.” The analysis also suggested that, “thousands more people may be at risk in those settings where up to a third of residents report suicidal thoughts.”
The investigation noted that each suicide has its own “blend of factors,” but it was concerning that “frail older Americans are managing to kill themselves in what are supposed to be safe, supervised havens raises questions about whether these facilities pay enough attention to risk factors like mental health, physical decline, and disconnectedness—and events such as losing a spouse or leaving one’s home.”
Compliance Perspective
Failing to carefully assess factors like the mental health, physical decline, and disconnectedness, or the impact of traumatic events, e.g., losing a spouse or leaving one’s home, when conducting residents’ suicide risk assessments, and failing to incorporate individualized prevention strategies into care plans that guide daily care routines may be considered provision of sub-standard quality of care in violation of state and federal regulations.
Discussion Points:
- Review policies and procedures regarding prevention of suicide and suicide ideation.
- Train staff to include mental health, physical decline, disconnectedness, and other related factors when conducting suicide risk assessments for residents. Teach staff the risk factors for suicide and the importance of immediately reporting any identified indicators.
- Periodically audit to discover if residents who expired in the facility may have had unidentified suicide concerns.
SUICIDE PREVENTION IN LONG-TERM CARE SETTINGS
REDUCING THE RISK OF RESIDENT INDUCED HARM TO SELF OR OTHERS
