The goal of this chapter is to assess major impacts at the end of life, and whether patients are able to obtain the services which enable them to maintain independence and dignity consistent with their wishes.
In general, since 1985, both males and females are living longer
Tuolumne County women over 64 years old fall more than their male or female peers in the region
Tuolumne County’s 3-year average hospice utilization rate of 49% is higher than the state average of 43.3%; but significantly less than the The Let’s Get Healthy California 2022 target rate is 54%
Tuolumne County has 259 of the 557 skilled nursing beds in the three counties; off these 74 are designated for memory care. Tuolumne County has 252 of the 529 assisted living beds in the three counties
The most common cause of death in Tuolumne County is cardiovascular disease; this combines heart disease and stroke
Tuolumne County’s 5-year average suicide rate of 18.5/100,000 population is equivalent to other rural counties
- Tuolumne County women over 64 years old fall more than their male or female peers in the region.
- One out of three adults age 65 and older falls each year; but less than half talk to their healthcare providers about it.
- Among older adults (those 65 or older), falls are the leading cause of injury death. They are also the most common cause of nonfatal injuries and hospital admissions for trauma. In the U.S. in 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized.
- Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, or head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.
- Falls are the most common cause of traumatic brain injuries (TBI).
Skilled Nursing and Assisted Living ^
- The three counties combined offer 557 skilled nursing beds, of which 259 skilled nursing bed are in Tuolumne County.
Tuolumne County has 252 of the 529 assisted living beds in the three counties.
- Of these 74 are designated for memory care.
- Calaveras and Amador Counties do not have any dedicated memory care beds, but all the facilities take residents with dementia.
- Of the Tuolumne County beds, 19 in local skilled nursing facilities are designated for memory care and 42 designated for memory care in a Residential Care Facilities for the Elderly.
- Amador and Tuolumne Counties have more assisted living beds per one thousand 65+ than Calaveras County.
- Calaveras County has fewer of both types of care for older adults.
- Tuolumne County’s 3-year average hospice utilization rate of 49% is higher than the state average of 43.3%; The Let’s Get Healthy California 2022 Target rate is 54%.
- The majority of patients were enrolled for less than 1 month, which is an area for improvement.
- Hospice care provides medical services, emotional support, and spiritual resources for people who are in the last stages of a terminal illness, such as cancer or heart failure.
- Examining hospice enrollment and length of stay helps us measure the rate of use and determine if under- utilization is occurring.
- Hospice experts often recommend that patients are in Hospice care for at least a month, and preferably 6 months. This avails the patient and the family optimum access to the full benefit of hospice services.
- Tuolumne County’s hospice is strictly an in-home support program, lacking an inpatient service and lacking a residential facility.
- In Tuolumne County, both men and women are living longer. Life expectancy for a newborn in Tuolumne County in 2013 is 81 years for a female and 77 years for a male
- This may be a minor decrease from 2011. Further analysis will determine if this becomes a trend, which may be attributable to diet and physical activity levels in younger generations leading to higher rates of chronic disease. Life expectancy for men at age 65 in the United States is 76.4; for women it is 81.2.
Cause of Death ^
- The most common cause of death in Tuolumne County is cardiovascular disease; this combines heart disease and stroke. This is the most common cause of death for California as well.
- Second most common cause of death in Tuolumne County, as with California, is cancer.
- Chronic diseases including heart disease, stroke, cancer, chronic respiratory diseases, Alzheimer’s, diabetes, and chronic liver disease cause the majority of death in Tuolumne County and California.
Suicide Deaths ^
- Tuolumne County’s 5-year average suicide rate of 18.5/100,000 population is equivalent to other rural counties.
- Generally, rural counties haves a higher rate of suicide when compared to the state or urban areas. Due to our small population size, the rates can seem to vary greatly year to year.
- What is very clear, however, is that the majority of reported suicides are occurring in middle aged men.
- This is an important demographic to focus interventions towards.