Factors influencing home discharge after inpatient rehabilitation of older patients: a systematic review

Abstract

BackgroundAlthough rehabilitation for older patients has the potential to improve function and prevent admission to nursing homes, returning home after discharge is not possible for all patients. Better understanding of patient factors related to discharge home may lead to more realistic rehabilitation goals, more targeted rehabilitation interventions and better preparation of both patient and informal caregiver for discharge. Various studies provided insight into factors related to home discharge after stroke rehabilitation, but we still lack insight into factors related to home discharge in non-stroke patients. Therefore, the aim of this review is to provide an overview of factors influencing home discharge in older non-stroke patients admitted to an inpatient rehabilitation unit.MethodsA systematic literature search was executed in the databases PubMed, EMBASE, CINAHL and Web of Science to retrieve articles published between January 2000 and October 2015. The search focused on factors related to home discharge after rehabilitation for older patients. Studies were included if home discharge after rehabilitation was assessed as an outcome measure and if the non-stroke population was, on average, 65 years or older and admitted to an inpatient rehabilitation unit.ResultsEighteen studies were included. The methodological quality was moderate to good in 15 studies. The factors significantly associated with home discharge are younger age, non-white ethnicity, being married, better functional and cognitive status, and the absence of depression.ConclusionsBecause various factors are significantly associated with home discharge of older non-stroke patients after rehabilitation, we recommend assessing these factors at admission to the rehabilitation unit. Further research into the factors that lack sufficient evidence concerning their association with home discharge is recommended.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0187-4) contains supplementary material, which is available to authorized users.

Use of a functional mobility measure to predict discharge destinations for patients admitted to an older adult rehabilitation ward: A feasibility study

“…It has not been previously established that a single functional mobility measure, the MEMS score at admission and discharge, predicts discharge destination with 71% accuracy. In contrast to other studies, the primary reason for admission was a significant predictor of discharge destination 10, 11, but age 10, 12, 13, 18, gender 13 and ethnicity 10 were not. We suggest that this study is also more generalisable than others that examined factors affecting discharge destination in discrete older adult populations, such as medical 13, stroke 9, 12, 14, 15 and hip fracture 18.…”

“…Early discharge planning for the older adult has been shown to reduce hospital readmissions, duration of hospital readmissions and all‐cause mortality, and to improve quality of life 6, 7, 8. Recent systematic reviews identified many social, physical and cognitive factors that predict discharge destination for stroke 9 and non‐stroke patients 10. Lindenberg et al 11 found that diagnosis was not associated with discharge destination in a heterogeneous group of older patients undergoing rehabilitation who had previously lived at home.…”

Evidence-Based Stroke Rehabilitation

“…Early supported discharge reduces the length of stay, and according to systematic Cochrane review adds to activities of daily life of stroke patients. Long term rehabilitation support of patients with stroke is essential for further improvement of outcome, independence, and active life [29].…”

İnme Hastalarinda Ni̇ntendo Wi̇i̇ Oyunlarinin Denge Ve Üst Ekstremi̇te Fonksi̇yonlarina Etki̇si̇

“…İnme rehabilitasyonunda nörogelişimsel tedavi (NDT) uygulamaları, yardımcı cihaz kullanımı, klasik fizyoterapi yaklaşımları sıklıkla uygulanan yaklaşımlardır (5,6). Bu uygulamalardan Bobath NDT nöral yaklaşımları temel olarak, nöral ve fizyolojik yapıların uyarılması yoluyla hastanın fonksiyonunun geri kazanılmasını amaçlamaktadır.…”

“…Bu uygulamalardan Bobath NDT nöral yaklaşımları temel olarak, nöral ve fizyolojik yapıların uyarılması yoluyla hastanın fonksiyonunun geri kazanılmasını amaçlamaktadır. Hastayı bir bütün olarak ve tedaviyi bireyin ihtiyaçlarına uygun hale getiren Bobath NDT yaklaşımları, fonksiyon odaklı, hastanın tedaviye aktif katılının önemsen-diği bireye özel bir tedavi yaklaşımıdır (6). Böyle-ce uygun postüral kontrolün yeniden kazanılması sağlanmaktadır.…”