scholarly journals Cognitive and Functional Impairment of Hospitalized Patients over 65 Years of Age

2013 ◽  
Vol 4 (1) ◽  
pp. 5-18
Author(s):  
Mª José Calero-García ◽  
Alfonso J. Cruz Lendínez
Keyword(s):  
Cognitive Impairment ◽  
Marital Status ◽  
Acute Care ◽  
Functional Impairment ◽  
Acute Care Hospital ◽  
Education Level ◽  
Care Hospital ◽  
Elderly Men ◽  
Time Of Admission ◽  
The Relationship

The first objective of this research is to establish and study how the different stages of cognitive impairment and the levels of dependence evolve in patients over 65 years of age, admitted to an acute care hospital, as well as the relationship between these factors and the different social and demographical variables. The results show that the level of dependence decreases suddenly at the time of admission and undergoes a slight recovery at the time of discharge. Although this recovery continues at home after discharge, patients do not get the same level of independence that they used to have before admission. In addition, significant differences in terms of age, marital status and education level were found. In general, our results show that elderly men over 80 years of age, without no education and widowers are more likely to suffer from severe cognitive impairment and be more functionally dependent when admitted to hospital.

scholarly journals Cognitive and Functional Impairment of Hospitalized Patients over 65 Years of Age

2013 ◽  
Vol 4 (1) ◽  
pp. 5-18
Author(s):  
Mª José Calero-García ◽  
Alfonso J. Cruz Lendínez
Keyword(s):  
Cognitive Impairment ◽  
Marital Status ◽  
Acute Care ◽  
Functional Impairment ◽  
Acute Care Hospital ◽  
Education Level ◽  
Care Hospital ◽  
Elderly Men ◽  
Time Of Admission ◽  
The Relationship

The first objective of this research is to establish and study how the different stages of cognitive impairment and the levels of dependence evolve in patients over 65 years of age, admitted to an acute care hospital, as well as the relationship between these factors and the different social and demographical variables. The results show that the level of dependence decreases suddenly at the time of admission and undergoes a slight recovery at the time of discharge. Although this recovery continues at home after discharge, patients do not get the same level of independence that they used to have before admission. In addition, significant differences in terms of age, marital status and education level were found. In general, our results show that elderly men over 80 years of age, without no education and widowers are more likely to suffer from severe cognitive impairment and be more functionally dependent when admitted to hospital.

scholarly journals Impact of a dementia-friendly program on detection and management of patients with cognitive impairment and delirium in acute-care hospital units: a non-equivalent control group design

2021 ◽  
Author(s):  
Nina Weldingh ◽  
Marte Mellingsæter ◽  
Bendik Hegna ◽  
Jūratė Šaltytė Benth ◽  
Gunnar Einvik ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Control Group ◽  
Care Hospital ◽  
Control Group Design ◽  
Group Design ◽  
Hospitalised Patients ◽  
Number Of Patients ◽  
Equivalent Control

Abstract Background Frail older persons with cognitive impairment (CI) are at special risk of experiencing delirium during acute hospitalisation. The purpose of this study was to investigate whether a dementia-friendly hospital program contributes to improved detection and management of patients with CI and risk of delirium at an acute-care hospital in Norway. Furthermore, we aimed to explore whether the program affected the prevalence of delirium, pharmacological treatment, 30-day re-hospitalisation, 30-day mortality and institutionalisation afterwards. Methods This study had a non-equivalent control group design and a historical control group. It was conducted at two different medical wards at a large acute-care hospital in Norway from September 2018 to December 2019. A total of 423 acute hospitalised patients 75 years of age or older were included in the study. Delirium screening and cognitive tests were recorded by research staff with the Four Assessment Test (4AT) and the Confusion Assessment Measure (CAM), while demographic and medical information was recorded from patient journals. Results Implementation of the dementia-friendly hospital program did not show any significant effect on the identification of patients with CI. However, the proportion of the patients with CI who received preventive measures increased by 32.2% (P < .001), compared to the control group. The share of patients screened with 4AT within 24 hours increased from 0–35.5% (P < .001). Furthermore, the number of patients with CI who were prescribed antipsychotic/hypnotic medications was reduced by 24.5% (P < .001). There were no differences in delirium, 30-day readmission or 30-day mortality. Conclusions Implementation of a model for early screening and multifactorial nonpharmacological interventions for patients with CI and delirium using quality improvement methodology may improve management of this patient group, increase staff awareness of family involvement, and reduce prescriptions of antipsychotics, hypnotics and sedatives. Trial registration: The protocol of this study was retrospectively registered in the ClinicalTrials.gov Protocol Registration and Results System with the registration number: NCT04737733 and date of registration: 03/02/2021.

scholarly journals Communication behavior of cognitively impaired older inpatients

2019 ◽  
Vol 52 (S4) ◽  
pp. 264-272
Author(s):  
Eva-Luisa Schnabel ◽  
Hans-Werner Wahl ◽  
Susanne Penger ◽  
Julia Haberstroh
Keyword(s):  
Cognitive Impairment ◽  
Psychometric Properties ◽  
Acute Care ◽  
Older Patients ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Acute Care Hospitals ◽  
Well Being ◽  
Communication Behavior ◽  
Care Hospital

Abstract Background and objective Acutely ill older patients with cognitive impairment represent a major subgroup in acute care hospitals. In this context, communication plays a crucial role for patients’ well-being, healthcare decisions, and medical outcomes. As validated measures are lacking, we tested the psychometric properties of an observational instrument to assess Communication Behavior in Dementia (CODEM) in the acute care hospital setting. As a novel feature, we were also able to incorporate linguistic and social-contextual measures. Material and methods Data were drawn from a cross-sectional mixed methods study that focused on the occurrence of elderspeak during care interactions in two German acute care hospitals. A total of 43 acutely ill older patients with severe cognitive impairment (CI group, Mage ± SD = 83.6 ± 5.7 years) and 50 without cognitive impairment (CU group, Mage ± SD = 82.1 ± 6.3 years) were observed by trained research assistants during a standardized interview situation and rated afterwards by use of CODEM. Results Factor analysis supported the expected two-factor solution for the CI group, i.e., a verbal content and a nonverbal relationship aspect. Findings of the current study indicated sound psychometric properties of the CODEM instrument including internal consistency, convergent, divergent, and criterion validity. Conclusion CODEM represents a reliable and valid tool to examine the communication behavior of older patients with CI in the acute care hospital setting. Thus, CODEM might serve as an important instrument for researcher and healthcare professionals to describe and improve communication patterns in this environment.

Better Together? An Examination of the Relationship Between Acute Care Hospital Mergers and Patient Experience

2020 ◽  
Vol 65 (5) ◽  
pp. 330-343
Author(s):  
Timothy Attebery ◽  
Larry R. Hearld ◽  
Nathan Carroll ◽  
Jeff Szychowski ◽  
Robert Weech-Maldonado
Keyword(s):  
Acute Care ◽  
Patient Experience ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Hospital Mergers ◽  
The Relationship

scholarly journals Impact of a Dementia-friendly Program on Detection and Management of Patients with Cognitive Impairment and Delirium in Acute-care Hospital Units: A Controlled Clinical Trial Design

2021 ◽  
Author(s):  
Nina Mickelson Weldingh ◽  
Marte Rognstad Mellingsæter ◽  
Bendik Westlund Hegna ◽  
Jūratė Šaltytė Benth ◽  
Gunnar Einvik ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cognitive Impairment ◽  
Acute Care ◽  
Trial Design ◽  
Acute Care Hospital ◽  
Clinical Trial Design ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Care Hospital ◽  
Early Screening

Abstract Background: Frail older persons with cognitive impairment (CI) are at special risk of experiencing delirium during acute hospitalisation. The purpose of this study was to investigate whether a dementia-friendly hospital program contributes to improved detection and management of patients with CI and risk of delirium at an acute-care hospital in Norway. Furthermore, we aimed to explore whether the program affected the prevalence of delirium, pharmacological treatment, 30-day re-hospitalisation, 30-day mortality and institutionalisation afterwards. Methods: This study had a controlled clinical trial design with a historical control group. It was conducted at two different medical wards at a large acute-care hospital in Norway from September 2018 to December 2019. A total of 423 acute hospitalised patients 75 years of age or older were included in the study. Delirium screening and cognitive tests were recorded by research staff with the 4 ‘A’s Test (4AT) and the Confusion Assessment Measure (CAM), while demographic and medical information was recorded from the electronic medical records (EMR). Results: Implementation of the dementia-friendly hospital program did not show any significant changes in the identification of patients with CI. However, the share of patients screened with 4AT within 24 hours increased from 0% to 35.5% (P<.001). The proportion of the patients with CI identified by the clinical staff, who received measures to promote “dementia-friendly” care and reduce the risk for delirium increased by 32.2% (P<.001), compared to the control group. Furthermore, the number of patients with CI who were prescribed antipsychotic, hypnotic or sedative medications was reduced by 24.5% (P<.001). There were no differences in prevalence of delirium, 30-day readmission or 30-day mortality. Conclusions: A model for early screening and multifactorial non-pharmacological interventions for patients with CI and delirium may improve management of this patient group, and reduce prescriptions of antipsychotic, hypnotic and sedative medications. The implementation in clinical practice of early screening using quality improvement methodology deserves attention. Trial registration: The protocol of this study was retrospectively registered in the ClinicalTrials.gov Protocol Registration and Results System with the registration number: NCT04737733 and date of registration: 03/02/2021.

Relationship Between Acute Care Hospital-Based Factors and Discharge Destination for Rehabilitation Following a Hip Fracture

2002 ◽  
Vol 21 (2) ◽  
pp. 187-194 ◽  
Author(s):  
Bert M. Chesworth ◽  
Mark Speechley ◽  
Kathleen Hartford ◽  
Richard Crilly
Keyword(s):  
Hip Fracture ◽  
Home Care ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Teaching Hospitals ◽  
Care Hospital ◽  
Logistic Regression Models ◽  
Teaching Status ◽  
Acute Rehabilitation ◽  
The Relationship

ABSTRACTHospitals may transfer seniors with a hip fracture to various rehabilitation settings. Knowing the relationship between hospital teaching status and post-acute rehabilitation setting may help evaluations of the transfer from acute care. The purpose of this study was to determine the relationship between hospital teaching status and rehabilitation destination following acute care in seniors with a hip fracture. Hospital separations were linked with home care records to identify hip fractures and hospital-based or home care rehabilitation (n = 806). Two logistic regression models determined the likelihood of transfer to any rehabilitation destination and to hospital-based versus home care rehabilitation. Teaching hospitals were no more likely than non-teaching hospitals to discharge patients to any rehabilitation (OR 1.20, 95% CI 0.88,1.65). However, among those referred to rehabilitation, the odds of discharge to hospital-based versus home care rehabilitation were almost four times greater for patients in teaching hospitals (OR 3.76, 95% CI 2.23, 6.37). The results are consistent with the availability of post-acute rehabilitation in the planning area. Future study of post-acute rehabilitation outcomes should consider hospital teaching status as an indicator of how hospital-based factors may affect the utilization of post-acute rehabilitation.

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