frailty, measured by the FI-CGA, was independently associated with a higher risk of death and other adverse outcomes in older people admitted to an acute care hospital.

We examined social problem solving in schizophrenia. Twenty-seven schizophrenic patients in an acute hospital, 19 patients with bipolar disease, and 17 demographically matched nonpatient controls were tested on an empirically developed problem-solving battery that assessed the ability to generate solutions to problems, the ability to evaluate the effectiveness of solutions, and the ability to implement solutions in a role-playing format. Schizophrenic Ss were impaired on all 3 problem-solving domains compared with the nonpatient controls, but bipolar Ss were equally impaired. Several alternative explanations for these findings were considered. The most compelling hypothesis is that the deficits resulted from different factors: cognitive impairment for schizophrenic Ss and acute illness for bipolar Ss. However, longitudinal studies are required to determine whether problem-solving deficits in schizophrenic patients persist during periods of remission. Implications for rehabilitation strategies are discussed.

The development of a multimethod social problem-solving battery for schizophrenia is described. The battery is unique in that empirical methods were used throughout its development. The battery includes components that tap skills for response generation and response evaluation. The behavioral components of social problem solving are assessed in an extended role-play format. Individuals with schizophrenia and bipolar disorder, as well as nonpatient controls, completed the social problem-solving battery and cognitive measures. Subjects in the schizophrenia group performed more poorly than controls on measures of the ability to generate and evaluate response alternatives, as well as on the role-play test. The two patient groups did not differ in performance on any of the social problem-solving components. Appropriateness of affect was the most powerful predictor of problem-solving effectiveness.

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Background In the absence of guidance from clinicians identifying patients who have the greatest potential to improve function as a benefit of skilled therapy, and writing orders to assure adequate therapy minutes, rehabilitation for the most vulnerable might not have been possible without objective assessment tools. The Frailty Index (FI) is one objective metric for identifying rehabilitation potential. The aim of this study was to evaluate the use of routinely collected data and predictive analytics of FI related to function to estimate rehabilitative potential. Methods Retrospective analysis of patients admitted into a large urban skilled nursing facility (SNF) in Western New York for post-acute rehabilitation over a nine-month period (N = 341). Using data collected in the Minimum Data Set (MDS), the change in the GG function scores from admission to discharge (GG AvD/C) was computed for each patient. The study utilized a multiple regression modeling approach to evaluate the variation of the GG AvD/C score across the different categories of frailty. Results The results of this analysis suggest that by observing a patient's FI near time of admission, the clinician can make a recommendation, based on an objective metric, when ordering patient treatment frequencies and time, based on the patient’s potential for functional gains. Conclusions Using a FI to categorize patients into Frailty Risk Groups provides an opportunity to predict the amount of functional improvement from start of care to discharge as measured using MDS GG functional scores.