Background: Accurate survival time estimates aid end-of-life medical decision-making. Objectives: Develop an interpretable survival model for elderly residential aged care residents using advanced machine learning. Setting: A major Australasian residential aged care provider. Participants: Residents aged 65+ admitted for long-term care from July 2017 to August 2023. Sample size: 11,944 residents across 40 facilities. Predictors: Factors include age, gender, health status, co-morbidities, cognitive function, mood, nutrition, mobility, smoking, sleep, skin integrity, and continence. Outcome: Probability of survival post-admission, specifically calibrated for 6-month survival estimates. Statistical Analysis: Tested CoxPH, EN, RR, Lasso, GB, XGB, and RF models in 20 experiments with a 90/10 train/test split. Evaluated accuracy using C-index, Harrell's C-index, dynamic AUROC, IBS, and calibrated ROC. Chose XGB for its performance and calibrated it for 1, 3, 6, and 12-month predictions using Platt scaling. Employed SHAP values to analyze predictor impacts. Results: GB, XGB, and RF models showed the highest C-Index values (0.714, 0.712, 0.712). The optimal XGB model demonstrated a 6-month survival prediction AUROC of 0.746 (95% CI 0.744-0.749). Key mortality predictors include age, male gender, mobility, health status, pressure ulcer risk, and appetite. Conclusions: The study successfully applies machine learning to create a survival model for aged care, aligning with clinical insights on mortality risk factors and enhancing model interpretability and clinical utility through explainable AI.

Care patients could see at home visits replaced by a call from an AI-powered voice assistant in a new British trial. Dubbed'Siri for care', a human-like virtual assistant will ring patients once a week to ask a list of automated questions. An algorithm will then analyse the answers and alert carers if there are any deteriorations in health so they can arrange a doctor's visit. Similar trials in Europe have reduced A&E visits by 55 per cent, according to the tech company behind it. The new technology will be tested out on patients in domiciliary care for those who are living independently but who rely on helpers to visit them regularly.