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Aim: To examine the effects of a simplified reablement program on physical function and quality of life in hospitalized older patients., Methods: The randomized controlled trial enrolled 114 older patients aged ≥65 years who, 2 weeks before admission, had been able to walk independently. Patients randomized to the reablement group received supervision and assistance to carry out the simplified reablement program 30 min daily during their hospital stay. Patients in the reminding group received only oral encouragement to continue the reablement program for 30 min daily. The control group received only usual care that included medical intervention consistent with the patient's diagnosis. The main outcome was improvement in physical function, including the modified version of the Katz Activities of Daily Living (ADL) score, Timed Up and Go test (TUG) and Hand Grip Strength (HGS). Secondary outcomes included the EuroQoL 5 Dimension (EQ-5D) Questionnaire and Visual Analog Scale (VAS)., Results: The intervention had no significant effect on the Katz ADL score. However, a significant within-group improvement in TUG occurred in the reminding group and reablement group. In addition, a significant time-dependent improvement in HGS occurred only in the reablement group. With respect to secondary outcomes, the EQ5D score improved significantly only in the reablement group at 3 months after discharge., Conclusions: The simplified reablement program may be beneficial to optimize physical function and improve quality of life in hospitalized older patients. It is recommended that health professionals should assist or encourage older patients to do simplified reablement during their hospital stay. Geriatr Gerontol Int 2020; 20: 436-442., (© 2020 Japan Geriatrics Society.)

Aims and Objectives: To explore the incidence, associated factors and adverse outcomes for initial inappropriate use of urinary catheters in hospitalised older patients., Background: Urinary catheters can lead to substantial complications. The related factors and adverse outcomes associated with initial inappropriate urinary catheter use among hospitalised older patients have not been studied., Design: Prospective cohort study., Methods: A total of 321 older patients admitted to the hospital in southern Taiwan having urinary catheters placed within 24 hours of admission were recruited. Demographic factors, voiding function history, health conditions and care conditions of catheter placement were collected through a review of medical records, interviewing participants or their primary caregivers. Catheter-associated urinary tract infection during hospitalisation, transfer to a nursing home, length of hospital stay and change in activities of daily living determined as outcomes. Criteria for urinary catheter placement were developed to identify inappropriate use., Results: The incidence of initial inappropriate use of urinary catheters among hospitalised Taiwanese older patients was 38·3%. The rationale most often reported for initial inappropriate use was 'convenience of care' (49·6%). Factors associated with initial inappropriate use were, chronic constipation, urinary tract infection history, medical treatment diagnosis, cognitive impairment, depressive symptoms and independence in activities of daily living and, insertion of catheter during evening and night shifts and lack of nursing documentation of the rationale for catheterisation. Patients with initial inappropriate use showed greater decline in activities of daily living function between admission and discharge., Conclusion: Older patients with greater care needs may become the victims of initial inappropriate use of urinary catheters. Inappropriate use may devastate the activities of daily living in older patients. Nurses' awareness of indications for urinary catheters may prevent inappropriate use., Relevance to Clinical Practice: A policy to strengthen nurses' awareness of the use of urinary catheters is needed in Taiwan., (© 2015 John Wiley & Sons Ltd.)

Aims and Objectives: To delineate the trajectories of functional status over four time points and to examine predictors of functional decline (FD) in hospitalised older patients., Background: About 30-60% of the older patients develop new dependence in activities of daily living (ADL) during a hospital stay, which results in progressive disability after discharge. The functional trajectories and risk factors of FD among hospitalised older patients require identification., Design: A cohort study., Methods: The study consecutively recruited 273 patients aged 65 and older admitted to a medical centre in southern Taiwan. Functional trajectory, by ADL score, was observed at four time points: two weeks before admission, admission, discharge and three months after discharge. The ADL score two weeks before admission was used as a baseline functional status., Results: Eighty-three (30·4%) patients experienced FD at three months after discharge. Functional trajectory as shown by ADL scores indicated that all 273 patients dropped steeply at admission and that two-thirds were gradually restored three months after discharge. Logistic regression revealed that the number of falls in the past year, Instrument Activities of Daily Living (IADL) status before admission, comorbidity and ADL decline between preadmission and discharge were significant predictors of FD three months after discharge. The ADL score decline during hospitalisation was the mediator of FD three months after discharge., Conclusions: Findings indicate that the ADL function of those hospitalised older patients who reported having fallen more often in the previous year had more comorbidity, had a lower IADL score, and had more ADL score decline before admission and discharge would continue to decline after discharge., Relevance to Clinical Practice: Clinical nurses can integrate the finding of this study with Comprehensive Geriatric Assessment to tailor intervention to restore older patient's physical function during hospitalisation., (© 2013 Blackwell Publishing Ltd.)

The number of elderly patients in hospitals rises as a country's population ages. In Taiwan, roughly 27% of hospitalized patients are elderly. Previous studies have reported that 30% to 60% of hospitalized elderly patient experienced functional decline following discharge. This article reviews references on the predictors of functional decline in hospitalized elderly. Six predictors are summarized, including, senility, daily activity disturbance (activity of daily living, preadmission disability in instrument activity of daily life), cognitive impairment, diseases (diagnosis, depression, incontinence), and hospitalization (length of hospital stay, prior hospital utilization, and demographic characteristics [e.g., high body mass, low income, institutional resident]). Nursing interventions that have been shown to help moderate functional decline in elderly patients include the multidiscipline care model, creating an elder-friendly environment, and facilitating exercise programs. As healthcare costs are so high, the need to decrease negative outcomes in personal health is a pressing issue. Thus, identifying hospitalized elderly at risk and providing intervention to prevent disabilities is an important mission of healthcare providers.

This study investigated the relationships between types of activity and quality of life (QOL) for older men and women at different ages. Based on cross-sectional data that included 220 community-dwelling elderly persons aged 65 and older in southern Taiwan, the results showed that the participation rates in many activities declined with age for both genders. Social activity and solitary leisure activity were significantly associated with QOL for old-old men, but not for young-old men. Only social activity was significantly associated with QOL for young-old women, but there was no significant association between any activity and QOL for old-old women. [ABSTRACT FROM AUTHOR]

This study explores the gender differences in the relationship between social activity and quality of life (QOL). A cross-sectional survey of 220 community-dwelling elderly people was conducted in southern Taiwan. Social activity was classified into six categories. The brief version of the World Health Organization QOL (WHOQOL-BREF) was used to measure QOL. Findings revealed that the associations of six types of social activities with QOL were weaker among women than men. The regression analyses further showed that for women, only religious activity was positively related to total QOL, while for men only involvement in formal group activity was positively related to total QOL. [ABSTRACT FROM PUBLISHER]

Background and aims: The Timed up and Go Test (TUG) is recommended as a screening tool for fall risk in older people. It is assumed that this general mobility test is underpinned by physiological factors such as strength, coordination and balance. However, no studies have examined the range of physiological and psychological factors which influence performance on this test. The aim of this study was to examine the relative contributions of a range of sensorimotor, balance and psychological factors to TUG performance in a large sample of older people. Methods: 280 community-dwelling people aged 65 plus years (mean age 74.9, SD=6.4) underwent the TUG test, as well as quantitative tests of vision, peripheral sensation, strength, reaction time, balance, fear of falling, pain and vitality. Results: The time required to complete the TUG was significantly related to limitations in instrumental activities of daily living and fear of falling. Many physiological and psychological factors were significantly associated with TUG performance in univariate analyses. Stepwise multiple regression analyses identified knee strength, postural sway, reaction time, edge contrast sensitivity, MMSE score, SF12 body pain and general health scores, number of medical conditions and age as significant and independent predictors of TUG performance. Of these measures, the lower limb strength measure explained most variance in TUG times. However, other sensorimotor, balance, psychological and health measures provided important independent information. The combined set of variables explained 43.5% of the variance in TUG times (multiple r=0.65). Conclusions: Findings indicate that, in community-dwelling older people, TUG performance is influenced by lower limb strength, balance, reaction time, vision and pain, in addition to cognitive function and health status. [ABSTRACT FROM AUTHOR]