25 February 2020 - Newsletter

PROPER USE OF STATISTICS

According to a recent French national report, “a third of the elderly people living in institutions are in a degraded psychological state”. A figure to view with caution.

In its study published on January 31, the French Direction for Research, Studies, Evaluation and Statistics (Drees) aims to present the psychological state of elderly people. This work, like many others, is of real interest, it leads us to question our professions, our practices and our way of understanding the remaining abilities of residents when they enter a nursing home. It also recalls the alarming figures released in 2016 by the National Suicide Observatory regarding the suicide rate of the over-85, the highest in the population.
Here, the report highlights the significant use of antidepressants in nursing homes (47% of residents were prescribed antidepressants at least 3 times in the year, compared with 14% of people aged 75 and over living at home). It also reiterates the strong causal link between the residents’ relationship with their caregivers and their psychological well-being (27% of those who report having good relationships are suffering psychological distress compared with 72% of those with difficult relationships). Nevertheless, even if these figures lead us to continually question our practices and learn lessons, the fact is that the study takes some dubious and dangerous shortcuts.

For example: the report repeatedly compares nursing homes residents to the population aged 75 and over living at home. This comparison is meaningless as the average age of residents in nursing homes exceeds 85… and the prevalence of dependency is much higher within the population in institution than the population living at home… and the level of dependency and the health condition are some of the main factors influencing the resident’s psychological state.

On the specific case of antidepressants, the report underlines that “these prescriptions may reflect a better management of psychological problems in institutions”. This perspective is essential but easily overshadowed if we read the report a little quickly … or if we only focus on the title and the introduction summary, what a lot of people may do.

In short, this study, however rich in lessons, takes some dangerous shortcuts and offers observations that should be balanced to be useful and constructive. At the exact time when the entire sector is massively working on changing the image of its nursing homes and its professions. Too bad, isn’t it?