Acknowledgements endorsements Background methodology executive Summary 11 Recommendations 22 Article — general obligations 38

Deaths in Residential Disability and Aged Care Facilities

163. 
     Reviews of deaths of people with disability in residential disability facilities have revealed that there are a number of troubling issues contributing to premature deaths.⁸⁵ The most recent New South Wales report revealed the average age upon death was 54, which is 25 years younger than the life expectancy of the general population. It would appear that the problems faced in New South Wales are similar to those in other states and territories.⁸⁶ The main issues concern:
     
     1. 
        problems in meeting complex needs, including identification of nutrition and swallowing risks,⁸⁷ inadequate action to address emerging health concerns, inadequate guidance to staff as to how to meet the needs of some individuals and a lack of effective interagency work to provide coordinated support;
        
     2. 
        first aid not being provided or provided ineffectively and delays in seeking medical assistance; and
        
     3. 
        ‘Do not resuscitate’ directives placed on files when it was not clear if the person had provided informed consent for such directives.
        
164. 
     There are many younger people with disability living in residential aged-care facilities. (See also Article 19). Although there are mandatory reporting requirements for ‘unexpected’ and ‘accidental’ deaths, evidence suggests that most deaths of people under 50 years of age in residential aged care are not reported. For example, in June 2007, there were 210 people with disability under 50 years of age living in residential aged care in Victoria. There were an average of 21 deaths per year in this group, yet very little is known about the causes of the deaths, and three “preventable” deaths in this group were not reported to the coroner.⁸⁸