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New institutionalisation following acute hospital admission: a retrospective cohort study.
- Source :
- Age & Ageing; Mar2017, Vol. 46 Issue 2, p238-244, 7p, 3 Charts
- Publication Year :
- 2017
-
Abstract
- Background: institutionalisation following acute hospital admission is common and yet poorly described, with policy documents advising against this transition. Objective: to characterise the individuals admitted to a care home on discharge from an acute hospital admission and to describe their assessment. Design and setting: a retrospective cohort study of people admitted to a single large Scottish teaching hospital. Subjects: 100 individuals admitted to the acute hospital from home and discharged to a care home. Methods: a single researcher extracted data from ward-based case notes. Results: people discharged to care homes were predominantly female (62%), widowed (52%) older adults (mean 83.6 years) who lived alone (67%). About 95% had a diagnosed cognitive disorder or evidence of cognitive impairment. One-third of cases of delirium were unrecognised. Hospital stays were long (median 78.5 days; range 14-231 days) and transfers between settings were common. Family request, dementia, mobility, falls risk and behavioural concerns were the commonest reasons for the decision to admit to a care home. About 55% were in the acute hospital when the decision for a care home was made and 44% of that group were discharged directly from the acute hospital. Conclusions: care home admission from hospital is common and yet there are no established standards to support best practice. Decisions should involve the whole multidisciplinary team in partnership with patients and families. Documentation of assessment in the case notes is variable. We advocate the development of interdisciplinary standards to support the assessment of this vulnerable and complex group of patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- RISK factors of falling down
ACADEMIC medical centers
COGNITION disorders
CRITICAL care medicine
DELIRIUM
DEMENTIA
DOCUMENTATION
HOSPITAL care
LENGTH of stay in hospitals
HOSPITAL admission & discharge
INSTITUTIONAL care
MEDICAL needs assessment
MOVEMENT disorders
RESEARCH funding
WIDOWHOOD
DECISION making in clinical medicine
ADVANCE directives (Medical care)
HOME environment
DISCHARGE planning
RETROSPECTIVE studies
DATA analysis software
FAMILY attitudes
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 00020729
- Volume :
- 46
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Age & Ageing
- Publication Type :
- Academic Journal
- Accession number :
- 121488868
- Full Text :
- https://doi.org/10.1093/ageing/afw188