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Here are some questions about you

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This question is not about gender identity, but rather physiological sex.

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What is your age?

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What was the pleted?

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Select all that apply.

Has a doctor and/or another health care professional told you that you have one or more of the following diseases or chronic health conditions?

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Has a doctor and/or another health care professional told you that you have less than 6 months to live?

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Here are some questions about your ability to live on your own

Have you had any difficulty with the following tasks in the past week?

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How much difficulty did you have with those tasks in the past week?

Meal Preparation
House Keeping
Using the Telephone
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Have you had any difficulty with the following tasks in the past week?

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How much assistance did you need or have maintaining your personal hygiene in the past 3 days?

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How much assistance did you need or have using the bathroom/toilet in the past 3 days?

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How much assistance did you need or have getting around in the past 3 days?

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How much assistance did you need or have eating in the past 3 days?

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Has your ability to carry out these tasks gotten worse over the past 3 months?

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Has your ability to make decisions worsened over the last 90 days?

Example: when to get up or have meals, which clothes to wear, or what activities to do

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We would like to know whether you have experienced any symptoms or been prescribed any treatments associated with your illness(es).

Have you experienced any of the following symptoms or conditions in the past 3 days?

Have you experienced any of the following symptoms or conditions in the past 3 days?

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Have you experienced any of the following symptoms or conditions in the past 3 days?

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Have you been prescribed or are you currently receiving any of the following treatments?

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Have you been scheduled for or begun treatment?

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Chemotherapy
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In the past 3 months, how many times were you hospitalized?

example: admitted and stayed in a hospital overnight

In the past 3 months, how many times did you seek care in an emergency department?

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Frailty

Of 100 People

Risk of Death

Life Expectancy

Those living with frailty are at higher risks of declining health and death than what is expected based on their age alone.
Very High
High
Moderate
Low
Of 100 people with similar responses to you:
0 people lived past 1 year
0 people died within 1 year
Life Expectancy for people with the same responses:

"X" years

"X"%

of people died within "X" years

"X"%

of people survived past "x" years

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Your Results

RESPECT was created for people who are frail or nearing the end of life. It was designed to help inform discussions about end-of-life care and planning.

Your results reflect the outcomes for people who are like you. The calculated risk represents the average risk profiles for people in Ontario, Canada, who received home care between 2007 and 2014.

Life Expectancy

uncertainty:
People with similar responses to you live at least another   on average
3 months
1 year
5 years
25% of people died within 2.2 years
25% of people lived past 2.2 years

Additional Perspective

Of 100 people with similar responses to you;

0 people lived past 3 months

0 people died within 3 months

0%

Which means that based on your health profile and conditions, your chance of surviving past three months is 0%

Of 100 people with similar responses to you:

0 people lived past 1 year

0 people died within 1 year

0%

This means that based on your health profile and conditions, your chance of surviving past 1 year is 0%

Of 100 people with similar responses to you;

0 people lived past 5 years

0 people died within 5 years

0%

Which means that based on your health profile and conditions, your chance of surviving past 5 years is 0%

What Now?

Advance Care Planning

It's never too early to start reflecting on your values and wishes, and letting your loved ones know what kind of health and personal care you would want in the future if you are unable to speak for yourself. To learn more about Advance Care Planning (ACP) and start your own plan, please visit ACP in Canada for more information.

Community Supports

Do you need support with your daily activities or managing your health? Print this report and use it as a tool to start a conversation with your healthcare provider and loved ones.

Other Resources

Your care needs will evolve as you approach the end of life. Decisions regarding palliative and end-of-life care can be complex, varied, and sometimes stressful. Here are some tools that can help you in your healthcare decision-making with the support of your healthcare providers and loved ones.

If you need support with your daily activities or managing your health, print this ­report and use it as a tool to start a conversation with your healthcare ­professional and loved ones.

Print Results

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