A new online tool can help frail older adults and their clinicians calculate six-month life expectancy in order to better plan palliative care, according to real-world studies from Canada.

Medical researchers from the University of Ottawa developed the Risk Evaluation for Support: Predictions for Elder-life in the Community Tool, or RESPECT, to understand the changing care needs of older adults as they age. In pilot studies in Ontario, users were guided through the tool’s two-to-three minute questionnaire about health and the ability for self care. 

Using the responses, the tool’s algorithm provided an estimate of survival based on data gathered from 491,000 home care recipients with similar characteristics. 

Most people die of causes that are progressive with a predictable course, the researchers noted. But the RESPECT investigation found that the best predictors of impending palliative care needs are declines in a person’s ability to carry out activities of daily living. The need for help with hygiene, using the toilet and locomotion, were stronger predictors of six-month mortality than disease, reported first author Amy Hsu, M.D.

The RESPECT tool helped to make informed decisions in real-world studies.

The RESPECT calculator allows families and their loved ones to plan, said Hsu and colleagues from the Bruyère Research Institute and the University of Ottawa.

“Knowing how long a person has to live is essential in making informed decisions about what treatments they should get and where they should get them,” said senior author Peter Tanuseputro, M.D. “As a person gets closer to death, the balance shifts from having curative care as the primary goal, to care that maximizes a person’s quality of remaining life.”

Full findings were published in the CMAJ. The RESPECT tool can be found here.