Medical Alert: Automatic, daily telephone check-in service for Independent Living, Caregiving, and Elder Care

PERSONS FOUND IN THEIR HOMES HELPLESS OR DEAD

R. Jan Gurley, M.D., Nancy Lum, M.S., Merle Sande, M.D., Bernard Lo, M.D., and Mitchell H. Katz, M.D. ABSTRACT

Background Health care providers and providers of emergency services are sometimes called to help with people who are found alone in their homes either helpless or dead. It is not known who is at risk for being found helpless or dead, what the mortality rates are among those found alive, or how frequently this situation occurs.

Methods

We conducted a population-based study of patients who were found in their homes either helpless or dead. Over 12 weeks, paramedics employed by the city of San Francisco identified 387 such events involving 367 persons. We obtained information on these patients from the emergency-medical-services department or the hospitals to which they were taken and determined their outcomes.

Results

The median age of the persons found helpless or dead was 73 years; 51 percent were women. The frequency of such incidents increased sharply with age, from a rate of 3 per 1000 per year among those 60 to 64 years of age to 27 per 1000 per year among those 85 years of age or older. The highest rate was among men 85 years and older who were living alone (123 per 1000 per year). In 23 percent of the cases, the person was found dead; an additional 5 percent died in the hospital. Thus, total mortality was 28 percent. Of the patients found alive, 62 percent were admitted to the hospital. The average hospital stay was eight days, and 52 percent of those admitted required intensive care. Of the survivors, 62 percent were unable to return to living independently. The total mortality was 67 percent for patients who were estimated to have been helpless for more than 72 hours, as compared with 12 percent for those who had been helpless for less than 1 hour.

Conclusions

For elderly people who live alone, becoming incapacitated and unable to get help is a common event, which usually marks the end of their ability to live independently.

Source Information

From the Robert Wood Johnson Clinical Scholars Program, University of California, San Francisco (R.J.G., B.L.); the Department of Public Health, City and County of San Francisco (R.J.G., M.H.K.); the Joint Medical School Program, University of California, San Francisco and Berkeley (N.L.); and the Department of Medicine, San Francisco General Hospital, San Francisco (M.S.).

Address reprint requests to Dr. Gurley at the Department of Public Health, AIDS Office, Suite 500, 25 Van Ness Ave., San Francisco, CA 94102.