Table 2 Factors contributing to... | Emerald Publishing

Table 2

Factors contributing to premature mortality and preventable deaths as identified through focused groups

Underlying medical condition	Other physical health issues	Social factors	Other person specific factors	Process factors	Staffing and carers related issues
Constipation Dysphagia Asthma Respiratory conditions including COPD and bronchopneumonia Osteoporosis Arthritis Obesity or being under weight Neuro-degenerative conditions Dementia Neurological disorders Acquired brain injury Chest infections Skin conditions Congenital heart conditions Epilepsy Deformity/altered body shape Bronchial diseases Diabetes Endocrine conditions Cancer Reflux conditions Abnormal feeding pattern PEG Urinary tract infection Skin integrity Immunological disorders Sepsis Insomnia Pain Immunisation status Aspiration Choking Dehydration Malnutrition History of chest infections Microcephaly Circulatory diseases Congenital malformations Gastrointestinal issues Cardiac failure Genito-urinary conditions Hypertension Hypothyroidism	Mobility Level of activity (inactivity) Sensory impairments Poor bowel management Poor personal care/hygiene Difficulty taking bloods Needing oxygen therapy Hearing Vision Ambulation Level of support needed to eat and use the toilet Gastrostomy feeding Polypharmacy Down’s syndrome Syndrome with physical stigmata	Lack of meaningful activities Lack of employment opportunities Social circumstances Family circumstances Family history Poor relationships Low self-confidence Stigma Isolation Lifestyle Lack of support Socioeconomic status Limitations in education Transport difficulties	Level of intellectual disability Age Poor/limited case history Loss of personal history through multiple placements Vulnerability to exploitation Living circumstances Smoking Alcohol/ substance abuse Number of hospital admissions History of medical emergencies Autism spectrum conditions Mental health problems Challenging behaviour Self-harm Psychological factors Risk from others Anti-psychotic medications Long-term use of anti-psychotic medications Communication issues – receptive and expressive Difficulties with engagement Limited capacity	Equipment – amount required and availability Lack of understanding from professionals about the Mental Capacity Act Poor information sharing – with carers, with professionals and with the person Difficulty accessing primary care Difficult accessing secondary care Lack of reasonable adjustments Financial issues Transport problems Lack of accessible communication Discharge without adequate planning Those with continuing health-care funding Lack of annual health checks Post-op (lack of communication and/or reasonable adjustment) Transition from services Poor access to investigations Diagnostic overshadowing Lack of communication between professionals across different organisations Lack of social care Poor access to routine health checks	Care staff not recognising there is a problem in a timely manner Inconsistent staffing Poor recording of information Carers not acting on recommendations Care plans and risk assessments not being up to date Information on different IT systems Changing of staff teams Not using anticipatory care calendar or other health monitoring system Poor carer support

Underlying medical condition	Other physical health issues	Social factors	Other person specific factors	Process factors	Staffing and carers related issues
ConstipationDysphagiaAsthmaRespiratory conditions including COPD and bronchopneumoniaOsteoporosisArthritisObesity or being under weightNeuro-degenerative conditionsDementiaNeurological disordersAcquired brain injuryChest infectionsSkin conditionsCongenital heart conditionsEpilepsyDeformity/altered body shapeBronchial diseasesDiabetesEndocrine conditionsCancerReflux conditionsAbnormal feeding patternPEGUrinary tract infectionSkin integrityImmunological disordersSepsisInsomniaPainImmunisation statusAspirationChokingDehydrationMalnutritionHistory of chest infectionsMicrocephalyCirculatory diseasesCongenital malformationsGastrointestinal issuesCardiac failureGenito-urinary conditionsHypertensionHypothyroidism	MobilityLevel of activity (inactivity)Sensory impairmentsPoor bowel managementPoor personal care/hygieneDifficulty taking bloodsNeeding oxygen therapyHearingVisionAmbulationLevel of support needed to eat and use the toiletGastrostomy feedingPolypharmacyDown’s syndromeSyndrome with physical stigmata	Lack of meaningful activitiesLack of employment opportunitiesSocial circumstancesFamily circumstancesFamily historyPoor relationshipsLow self-confidenceStigmaIsolationLifestyleLack of supportSocioeconomic statusLimitations in educationTransport difficulties	Level of intellectual disabilityAgePoor/limited case historyLoss of personal history through multiple placementsVulnerability to exploitationLiving circumstancesSmokingAlcohol/ substance abuseNumber of hospital admissionsHistory of medical emergenciesAutism spectrum conditionsMental health problemsChallenging behaviourSelf-harmPsychological factorsRisk from othersAnti-psychotic medicationsLong-term use of anti-psychotic medicationsCommunication issues – receptive and expressiveDifficulties with engagementLimited capacity	Equipment – amount required and availabilityLack of understanding from professionals about the Mental Capacity ActPoor information sharing – with carers, with professionals and with the personDifficulty accessing primary careDifficult accessing secondary careLack of reasonable adjustmentsFinancial issuesTransport problemsLack of accessible communicationDischarge without adequate planningThose with continuing health-care fundingLack of annual health checksPost-op (lack of communication and/or reasonable adjustment)Transition from servicesPoor access to investigationsDiagnostic overshadowingLack of communication between professionals across different organisationsLack of social carePoor access to routine health checks	Care staff not recognising there is a problem in a timely mannerInconsistent staffingPoor recording of informationCarers not acting on recommendationsCare plans and risk assessments not being up to dateInformation on different IT systemsChanging of staff teamsNot using anticipatory care calendar or other health monitoring systemPoor carer support

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