DOES THE MORTALITY RISK INDEX PREDICT 6 MONTH MORTALITY IN RESIDENTS LIVING IN A DEMENTIA SPECIAL CARE CENTER?

Purpose: Predicting survival in patients with advanced dementia plays a vital role in the care planning process for these patients. A special care dementia center that is rooted in the philosophy of "humane care" and recognizing dementia as a terminal illness may actually contribute towards increasing life expectancy. This study was designed to test whether the residents of a special dementia care center have a longer life expectancy compared to usual nursing home residents based on a predictive formula developed by Mitchell et al entitled the Mortality Risk Index. If true, this would support the provision of "humane" supportive and non-aggressive or invasive care for patients with advanced dementia which would enable them a longer life expectancy with a focus on comfort care measures. Methods: This was a retrospective chart review of 236 residents who had resided at the JLWest Dementia Special Care Center and had expired over the past 10 years. The life expectancy was predicted utilizing the Mortality Risk Index Score (MRI) calculated from various items from the Minimum Data Set (MDS). Data elements (transcribed from original medical records) were collected from the MDS administered at approximately 6-month intervals, up to 3 years from the date of death. All data was entered into an SPSS Program. Results: The mean Mortality Risk Index for patients at the JLWest Center was 4.89. This value corresponds with a mean estimate of 0.292, indicating that 29.2% (a total of 69) residents would be expected to die within six months of the assessment. In reality 87 residents died within six months of the MDS, representing 36.9% of the resident population. Conclusions: The Mortality Risk Index Score under predicted the amount of deaths in the population at the JLWest dementia special care center. The MRI alone is not a sufficient predictor of death in these dementia patients, indicating there are other aspects related to the disease or care of the illness that must be factored into predicting death.