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.