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J Am Geriatr Soc. 2009 Feb;57(2):195-201. doi: 10.1111/j.1532-5415.2008.02107.x. Epub 2008 Dec 11.

Functional trajectories in older persons admitted to a nursing home with disability after an acute hospitalization.

Author information

1
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06510, USA. thomas.gill@yale.edu

Abstract

OBJECTIVES:

To characterize the functional trajectories of older persons admitted to a nursing home with disability after an acute hospitalization.

DESIGN:

Prospective cohort study of 754 community-living persons aged 70 and older who were initially nondisabled in four essential activities of daily living (ADLs).

SETTING:

Greater New Haven, Connecticut.

PARTICIPANTS:

The analytical sample included 296 participants who were newly admitted to a nursing home with disability after an acute hospitalization.

MEASUREMENTS:

Information on nursing home admissions, hospitalizations, and disability in essential ADLs was ascertained during monthly telephone interviews for up to 9 years. Disability was defined as the need for personal assistance in bathing, dressing, walking inside one's home, or transferring from a chair.

RESULTS:

The median time to the first nursing home admission with disability after an acute hospitalization was 46 months (interquartile range 27.5-75.5), and the mean number+/-standard deviation of ADLs that participants were disabled in upon admission was 3.0+/-1.2. In the month preceding hospitalization, 189 (63.9%) participants had no disability. The most common functional trajectory was discharged home with disability (46.3%), followed by continuous disability in the nursing home (27.4%), discharged home without disability (21.6%), and noncontinuous disability in the nursing home (4.4%). Only 96 (32.4%) participants returned home at (or above) their premorbid level of function.

CONCLUSION:

The functional trajectories of older persons admitted to a nursing home with disability after an acute hospitalization are generally poor. Additional research is needed to identify the factors responsible for these poor outcomes.

PMID:
19170778
PMCID:
PMC2676348
DOI:
10.1111/j.1532-5415.2008.02107.x
[Indexed for MEDLINE]
Free PMC Article

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