Discharging to a Nursing Home: Not a Terminal Event–A Follow-Up Study of Senior Motor Vehicle Crash Patients

Abstract

Discharge to a nursing home (NH) because of chronic debilitating diseases or old age is generally a terminal event. The purpose of this study was to evaluate the NH outcome of senior citizens injured in motor vehicle crashes (MVC) discharged to a NH. From 2000 through 2004, 157 patients 75 years and older were admitted to the hospital for MVC. Of these, 32 patients were discharged to a NH, and these patients or their proxies were interviewed by telephone in June 2005 to request information as to driving status before and after the MVC, feeding, expression, and locomotion status, and/or date of death. After discharged from the NH, 72 per cent (23/32) of the patients lived at home, 52.2 per cent (12/23) among the drivers returned to drive, and those with functional impairments (excluding the five NH deaths and four still remaining in a NH) at the time of hospital discharge had 100 per cent or partial improvement in three functional independent measures at the time of the interview: 5 cases in feeding, 2 in expression, and 20 in locomotion. Eleven of the 20 individuals dependent or partially dependent in locomotion status were fully independent. The majority of the senior patients discharged to a NH after a MVC returned to a normal life by going back home, driving again, and regaining functional activities after NH discharge. Discharge to a NH for elderly MVC trauma patients may be regarded as a stepping-stone to independent living rather than a final resting place.

Factors affecting residents transition from long term care facilities to the community: a scoping review

“…Study objectives and post-discharge outcomes are described in Table 2 while the purpose and main findings of all articles are presented in Table 3 . With the exception of seven articles [ 26 – 32 ], the majority of articles focused on older adults (29/36), specifically those aged 65 or greater [ 33 – 47 ]. A few articles focused on specialized populations that shared a similar characteristic such as persons with an intellectual disability [ 30 , 32 , 48 ] or persons who had a stroke [ 26 , 46 ].…”

“…A few articles focused on specialized populations that shared a similar characteristic such as persons with an intellectual disability [ 30 , 32 , 48 ] or persons who had a stroke [ 26 , 46 ]. One article focused on persons who had a common experience of a motor vehicle accident [ 33 ]. The majority of articles (30/36) included both males and females [ 26 , 28 , 30 – 37 , 39 – 59 ].…”

“…The majority of articles (30/36) included both males and females [ 26 , 28 , 30 – 37 , 39 – 59 ]. The main focus for most articles (21/36) was on resident profiles [ 26 , 28 , 32 , 33 , 35 , 36 , 40 – 47 , 51 , 53 – 57 , 60 ]. The study designs employed predominantly quantitative techniques [ 26 , 28 – 30 , 32 – 38 , 40 , 42 – 57 , 60 ].…”

“…Study sample sizes had a large range from less than 20 participants [ 31 ] to more than 500,000 participants in the largest sample [ 37 ]. Almost all studies were conducted in the US [ 27 – 30 , 33 – 39 , 41 , 42 , 44 , 45 , 47 – 55 , 57 – 61 ]. Non-US research in this area is scarce [ 26 , 31 , 32 , 40 , 43 , 46 , 56 ] and only one article used data gathered from more than one country [ 32 , 46 ].…”

Using Hospital Outcomes to Predict 30-Day Mortality Among Injured Patients Insured by Medicare

“…Several authors have pointed out that discharge destination is an important outcome to consider because observed hospital mortality may depend on the availability of skilled nursing beds in a given community or region. 11,[16][17][18] Although hospital administrators may strive for shorter LOS, this cannot be considered a good measure of clinical quality if it leads to increased mortality after hospital discharge. 19,20 Conversely, hospitals that tend to have longer LOS owing to limitations in the availability of subacute facilities should not necessarily be considered inferior simply because their measured in-hospital mortality may be greater than that in hospitals with shorter LOS.…”