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A systematic review of comprehensive geriatric assessment to improve outcomes for frail older people being rapidly discharged from acute hospital: ‘interface geriatrics’
- Authors:
- CONROY Simon Paul, et al
- Journal article citation:
- Age and Ageing, 40(4), July 2011, pp.436-443.
- Publisher:
- Oxford University Press
A systematic review on models of care for elderly people following admission to acute medical units, or emergency departments, and early discharge. Five, highly varied, randomised controlled trials were included in the systematic review. There was no firm evidence that either of the forms of comprehensive geriatric assessment (CGA) examined, whether nurse-led or geriatrician-led, has any effect on the outcomes reported – including mortality and readmission. Although there is no clear evidence of benefit with CGA in this population, due to the small number of trials identified, further well-designed research is justified.
A framework to discharge frail older people
- Author:
- LEES-DEUTSCH Liz
- Journal article citation:
- Nursing Times, 112(37/38), 2016, pp.13-15.
- Publisher:
- Nursing Times
A framework to discharge frail older patients who have had an unplanned admission to hospital and are subsequently discharged (or transferred)to another setting. It discusses current issues in discharge practice, briefly reviews the background policy to guide the discharge assessment of older people and examines challenges in discharging them from the acute setting. Finally, it uses an assessment framework to integrate current principles form national discharge guidance into practice. (Publisher abstract)
Informal caregivers' participation when older adults in Norway are discharged from the hospital
- Authors:
- BRAGSTAD Line Kildal, et al
- Journal article citation:
- Health and Social Care in the Community, 22(2), 2014, pp.155-168.
- Publisher:
- Wiley
This paper describes the participation of informal caregivers in the discharge process when patients aged 80 and over who were admitted from home to different hospitals in Norway were discharged to long-term community care. Data for this cross-sectional survey were collected through telephone interviews with a consecutive sample of 262 caregivers recruited between October 2007 and May 2009. The Discharge of Elderly Questionnaire was developed by the research team and was designed to elicit data concerning informal caregivers' self-reported perceptions on participation in the discharge process. A descriptive and comparative analysis of Thompson's levels of participation reported by the older generation (spouses and siblings) and the younger generation (adult children and children-in-law, nieces and grandchildren) was undertaken using bivariate cross-tabulations and chi-square tests for association and trend. Analyses showed that the younger generation of caregivers received and provided information to hospital staff to a greater degree than the older generation. Overall, 52% of the informal caregivers reported co-operating with the staff to a high or to some degree. A multivariate logistic regression analysis was used to analyse factors predicting the likelihood of informal caregivers reporting co-operation with hospital staff. The odds of younger generation caregivers reporting co-operation were more than twice as high as the odds of the older generation. Caregivers of patients with a hearing impairment had higher odds of reporting co-operation than caregivers of patients with no such impairment. The length of hospital stay, the caregiver's and patient's gender and education level were not significantly associated with caregiver's co-operation. The informal caregivers' experiences with information practices and user participation in hospitals highlight important challenges that must be taken seriously to ensure co-operation between families and hospitals when elderly patients are discharged back to the community. (Edited publisher abstract)
Hospital discharge for frail older people: a literature review with practice case studies
- Authors:
- TARABORRELLI Patricia, et al
- Publisher:
- Great Britain Scottish Office Central Research Unit;
- Publication year:
- 1998
- Pagination:
- 4p.
- Place of publication:
- Edinburgh
Outlines the findings of a study that identified and examined recent literatures relating to the discharge of frail older people and assessed the contribution of that literature to current practice. There are two main aspects to the study: an extensive review of the existing literature; and a review of case studies of discharge practice at four Scottish NHS Trusts, selected to represent a range of circumstances and catchment area populations.
How even the 90-year-olds leapt the barriers to home care
- Author:
- JEFFES Elizabeth
- Journal article citation:
- Care Plan, 1(3), March 1995, pp.13-15.
- Publisher:
- Positive Publications/ Anglia Polytechnic University, Faculty of Health and Social Work
Increasing numbers of very elderly people are being discharged from hospitals into expensive residential and nursing home care. Describes a project which demonstrated that even very frail elderly people can return home with proper support.
Reducing falls in older adults recently discharged from hospital: a systematic review and meta-analysis
- Authors:
- NASERI Chiara, et al
- Journal article citation:
- Age and Ageing, 47(4), 2018, p.512–519.
- Publisher:
- Oxford University Press
Background: older adults are known to have increased falls rates and functional decline following hospital discharge, with substantial economic healthcare costs. This systematic review aimed to synthesise the evidence for effective falls prevention interventions in older adults recently discharged from hospital. Methods: literature searches of six databases of quantitative studies conducted from 1990 to June 2017, reporting falls outcomes of falls prevention interventions for community-dwelling older adults discharged from hospital were included. Study quality was assessed using a standardised JBI critical appraisal tool (MAStARI) and data pooled using Rev-Man Review Manager® Results: sixteen studies (total sample size N = 3,290, from eight countries, mean age 77) comprising 12 interventions met inclusion criteria. Findings: home hazard modification interventions delivered to those with a previous falls history (1 study), was effective in reducing the number of falls (RR 0.63, 95%CI 0.43, 0.93, Low GRADE evidence). Home exercise interventions (3 studies) significantly increased the proportion of fallers (OR 1.74, 95%CI 1.17, 2.60, Moderate GRADE evidence), and did not significantly reduce falls rate (RR 1.27, 95%CI 0.99, 1.62, Very Low GRADE evidence) or falls injury rate (RR 1.16, 95%CI, 0.83,1.63, Low GRADE evidence). Nutritional supplementation for malnourished older adults (1 study) significantly reduced the proportion of fallers (HR 0.41, 95% CI 0.19, 0.86, Low GRADE evidence). Conclusion: the recommended falls prevention interventions for older adults recently discharged from hospital are to provide home hazard minimisation particularly if they have a recent previous falls history and consider nutritional supplementation if they are malnourished. (Edited publisher abstract)