Please use this identifier to cite or link to this item: https://doi.org/10.1111/jgs.17685
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dc.titleGeriatric home-based rehabilitation in Australia: Preliminary data from an inpatient bed-substitution model
dc.contributor.authorLoveland, Paula M
dc.contributor.authorReijnierse, Esmee M
dc.contributor.authorIsland, Louis
dc.contributor.authorLim, Wen Kwang
dc.contributor.authorMaier, Andrea B
dc.date.accessioned2022-11-28T10:34:35Z
dc.date.available2022-11-28T10:34:35Z
dc.date.issued2022-02-04
dc.identifier.citationLoveland, Paula M, Reijnierse, Esmee M, Island, Louis, Lim, Wen Kwang, Maier, Andrea B (2022-02-04). Geriatric home-based rehabilitation in Australia: Preliminary data from an inpatient bed-substitution model. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY 70 (6) : 1816-1827. ScholarBank@NUS Repository. https://doi.org/10.1111/jgs.17685
dc.identifier.issn0002-8614
dc.identifier.issn1532-5415
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/234871
dc.description.abstractBackground: The REStORing health of acutely unwell adulTs (RESORT) is an observational longitudinal cohort, including geriatric rehabilitation inpatients aged ≥65 years admitted to a geriatrician-led rehabilitation service at a tertiary hospital. The aim of this study is to describe a home-based bed-substitution rehabilitation model for geriatric inpatients, including patient phenotype, and health outcomes at preadmission, admission, discharge, and three-month follow-up. Methods: A standardized Comprehensive Geriatric Assessment was performed on admission and discharge, including demographics (home situation, cognitive impairment, medical diagnoses, etc.), frailty (Clinical Frailty Scale (CFS)), mobility (patient-reported and Functional Ambulation Classification), physical performance (Short Physical Performance Battery (SPPB), handgrip strength), and functional independence (Activities of Daily Living (ADL), Instrumental ADL (IADL)). Service provision data (health care staff visits, length of stay (LOS), and negative events (e.g., falls)) were extracted from medical records. Three-month outcomes included mobility, ADL and IADL scores, institutionalization, and mortality. Results: Ninety-two patients were included with a mean age of 81.1 ± 7.8 years, 56.5% female. Twenty-nine (31.5%) patients lived alone, 39 (42.4%) had cognitive impairment and the commonest geriatric rehabilitation admission reason was falls (n = 30, 32.6%). Patients received care from nurses, physicians, and a median of four (interquartile range (IQR) 3–6) allied health disciplines for a median LOS of 13.0 days (IQR 10.0–15.0). On a population level, patient mobility and functional independence worsened from preadmission to admission. CFS, SPPB, ADL, and IADL scores improved from admission to discharge, and seven (7.6%) patients fell. At three-month follow-up, patient-reported mobility was comparable to preadmission baseline, but functional independence (ADL, IADL) scores worsened for 27/69 (39.1%) and 28/63 (44.4%), respectively. Conclusions: Hospitalization-associated decline in mobility and functional independence improved at discharge and three-months, but was not fully reversed in the multidisciplinary home-based geriatric rehabilitation bed-substitution service. Future research should compare outcomes to equivalent hospital-based geriatric rehabilitation and evaluate patient perspectives.
dc.language.isoen
dc.publisherWILEY
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectGeriatrics & Gerontology
dc.subjectGerontology
dc.subjectgeriatrics
dc.subjecthome care services
dc.subjecthospital-based
dc.subjecthospital at home
dc.subjectrehabilitation
dc.subjectCOGNITIVE ASSESSMENT
dc.subjectKNEE ARTHROPLASTY
dc.subjectSCREENING TOOL
dc.subjectOLDER-PEOPLE
dc.subjectADULTS
dc.subjectFALL
dc.subjectCARE
dc.subjectHIP
dc.typeArticle
dc.date.updated2022-11-28T09:04:22Z
dc.contributor.departmentDEPT OF MEDICINE
dc.description.doi10.1111/jgs.17685
dc.description.sourcetitleJOURNAL OF THE AMERICAN GERIATRICS SOCIETY
dc.description.volume70
dc.description.issue6
dc.description.page1816-1827
dc.published.statePublished
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