This calculator is part of an active program of research around palliative care that continues to undergo evaluation for the public’s use. RESPECT and the information presented here are designed to support conversations about the care needs of frail older adults. The tool does not replace the relationship between a patient and their healthcare providers, and should not be used as a substitute for medical advice. We support a model of care that emphasizes shared decision-making, where patients’ needs and preferences are at the centre of all care-related discussions. As such, we encourage you to review the results with a qualified healthcare professional, as the estimates do not predict the outcome for any individual and should be used for information only.
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Do you want to know how long you will live? Has anyone ever talked to you about your end of life? This calculator identifies when a person may be nearing the end of life and provides information that helps to determine their care needs.
Disclaimer*:
This calculator does not predict the future for any single individual.
Despite most deaths being predictable, many residents who are at the end of life do not receive palliative care services
RESPECT is short for Risk Evaluation for Support: Predictions for Elder-life in the Community Tool. It was developed for frail older people who might need support and care in their homes. Technically, it is an algorithm that calculates a frail person’s survival—that is, how long they will live. Using the responses to 17 questions about their health and ability to care for themselves, the tool provides an estimate of a person’s survival based on information gathered on people who have similar characteristics.
RESPECT was designed for frail older adults living in the community who are uncertain about their survival and the family members and caregivers who support them. RESPECT can also be used by formal care providers—such as physicians, home care staff or palliative care teams—to understand their patient’s decline.
As a person’s health declines, they may need more support and care in their home. RESPECT calculates a person’s survival and provides information that can help them understand what type of care and services they may need. A patient can use this information to discuss their care needs with their caregivers and healthcare providers. Similarly, formal care providers can use this tool to discuss, with their patients, what can be expected as the patient approaches the end of life and plan for the support that their patient may need.
RESPECT was developed and validated using home care data from Ontario. We used data from 1.3 million Ontario home care assessments that were followed by 80,000 deaths between 2007 and 2014. The dataset contains detailed health information from the standardized Resident Assessment Instrument for Home Care, which case managers or care coordinators commonly use to assess the needs of frail individuals who might need home care.
RESPECT was designed for frail older adults living in the community, which includes those living in assisted living and retirement home communities, who might need support at home. People receiving care in other settings—such as those in long-term care or nursing homes—may have different underlying risks that contribute to their survival and RESPECT will not be able to accurately estimate the mortality risk for these populations.
RESPECT was created by the Project Big Life Team, which includes patients and caregivers to older adults who need care. The Project Big Life Team is led by researchers at the Ottawa Hospital, the Bruyère Research Institute, the University of Ottawa and ICES. ICES, formerly known as the Institute for Clinical Evaluative Sciences, is a not-for-profit research institute encompassing a community of research, data and clinical experts, and a secure and accessible array of Ontario's health-related data.
Through funding from the Canadian Institutes of Health Research, the Project Big Life Team will be collaborating with various healthcare providers and organizations to improve the integration of this information into existing electronic medical records. At this time, results generated from the online calculator can be printed and shared with a patient’s formal care provider and those in their circle of care.
Who funded this research?
Information provided by RESPECT is neither intended nor implied to be a substitute for professional medical advice. The calculator and its results are designed to complement and support discussions about a frail older person's care needs with their healthcare providers. You should not use estimates generated by RESPECT to infer the outcome for any single individual or make decisions about your life, finances or healthcare without consulting a qualified healthcare provider. We advise you to always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition or your prognosis.
Never disregard professional medical advice, delay seeking medical care, or make financial decisions solely based on information that you have received from RESPECT.
Accuracy of Risk Assessment
The predicted risk and reported survival are calibrated to the experience of frail older adults living in Ontario. The calculations may not reflect the risk for people from different populations, including those receiving care in other care settings (such as those living in nursing homes). Please see the discussion in our science section and FAQ for more information.
