May 21, 2025  – A comprehensive study has shed light on the significant declines experienced by residents upon being admitted into long-term care (LTC) facilities. The research, conducted by Ramtin Hakimjavadi, M.D.; Christina Y. Yin, MHS; Mary Scott, MSc; Robert Talarico, MSc; and colleagues, analyzed data from 120,238 individuals aged 65 and older admitted to LTC facilities in Ontario, Canada, between April 1, 2013, and March 31, 2018.

The study found that within five years of admission:

• 20% of residents lost decision-making capacity
• 13.4% became fully dependent, unable to care for themselves
• 7.7% lost the ability to communicate
• 32.8% developed incontinence

These findings underscore the progressive nature of decline among LTC residents and highlight the importance of early and proactive care planning, as well as the benefits of home care and home health, where individuals can remain living independently in the comfort of their home.

The study also examined median survival times following the onset of severe impairments. Residents who entered LTC in a state of total care dependence had the shortest median survival time of 45 days. Conversely, those who developed incontinence after admission had a longer median survival time of 356 days.

Age played a significant role in survival outcomes. Residents under 80 years old who experienced severe impairment had a median survival time of 133 days, compared to just 30 days for those aged 80 and older. Interestingly, residents admitted with dementia had a longer median survival time of 318 days, while those without dementia had a median of 74 days.

The researchers emphasized the need for shared understanding and open communication about the natural course of frailty trajectories in LTC settings. Such discussions can support resident-centered medical decision-making and ensure that care plans align with the evolving needs and preferences of residents.

This study provides valuable insights for healthcare providers, policymakers, and families, highlighting the importance of early intervention and tailored care strategies to address the complex needs of LTC residents.

For more detailed information, the full study can be accessed here.