New online calculator can help predict death and need for end-of-life care for frail older adults

A new risk calculator can help predict how long an older adult will live, and support end-of-life planning. The method used to develop the tool is published in CMAJ (Canadian Medical Association Journal).

Although most Canadians die from predictable causes and have health needs that can be met at home, only 20 per cent of people receive a physician home visit in their last year of life.

To help understand the changing care needs of older adults as they age and when they might be nearing the end of their lives, a team of researchers developed the Risk Evaluation for Support: Predictions for Elder-Life in the Community Tool (RESPECT). Find the RESPECT tool here.


The calculator, which predicts death within  six months, is based on data from more than 491 000 community-dwelling older adults who used home care in the 6-year period between 2007 and 2013.

“The RESPECT calculator allows families and their loved ones to plan,” says Dr. Amy Hsu, investigator at the Bruyère Research Institute, affiliate investigator at The Ottawa Hospital, and faculty in the Department of Family Medicine at the University of Ottawa. “For example, it can help an adult child plan when to take a leave of absence from work to be with a parent or decide when to take the last family vacation together.”

“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,” says Dr. Peter Tanuseputro, physician-scientist at The Ottawa Hospital and ICES, and investigator at the Bruyère Research Institute. “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.”

The tool was designed with patients and their care partners in mind and has been piloted in community settings in Ontario. It can also be used by physicians and home care staff, in addition to palliative care professionals.

“Predicting death in home care users: derivation and validation of the Risk Evaluation for Support: Predictions for Elder-Life in the Community Tool (RESPECT)” is published July 5, 2021.