Introduction: In the 2010 census, 11.9% of the Irish population were aged over 65 and nearly 5% of this group reside in long-term care facilities (LTCFs). In the past 18 months, 1,200 LTCF beds have been closed for various reasons resulting in residents being transferred between facilities. Our aim was to examine morbidity and mortality in residents relocated between LTCFs.
Methods: We studied the outcomes for residents from two LTCFs that care for the most highly dependent residents in our region. One LTCF closed completely and the second unit partially closed. We used the residents of the second unit who did not transfer as controls. A retrospective analysis was done recording: demographic data; cumulative illness (CIRS-G), dementia (CDR), mobility and functional level. As a measure of morbidity, we examined new antidepressant and antibiotic usage. Mortality at 30 and 90 days was recorded.
Results: We studied 76 transferred residents (mean age 82.1, male 38.2%) and 62 controls (mean age 82.4, male 33.9%). Both groups were highly dependent (modified Barthel index: control group 1.7 versus transfer group 2.6). Both groups had a high 90-day mortality (18.4 versus 17.7%). However, there was an increased early mortality in the transfer group, with two-thirds of deaths in the first 30 days. There was higher prescription rate of antibiotics among the relocated residents prior to transfer (59.2 versus 27.4%, P = 0.017). After transfer residents had a greater number of new antidepressant prescriptions than non-movers (19.7 versus 8.1%, P = 0.05).
Conclusions: Our results show an increased early mortality and increased mood disturbance in highly dependent residents that transfer LTCFs. The increased antibiotic use prior to relocation could relate to increased stress before transfer as demonstrated in other studies. Proper planning and vigilance by staff is essential to minimise any distress caused to patients during relocation.