Functional Assessment and Intervention by Nursing Assistants in Hospice and Palliative Care Inpatient Care Settings

ObjectivesReadmission and death are frequent after a hospitalisation and difficult to predict. While many predictors have been identified, few studies have focused on functional status. We assessed whether performance-based functional impairment at discharge is associated with readmission and death after an acute medical hospitalisation.Design, setting and participantsWe prospectively included patients aged ≥50 years admitted to the Department of General Internal Medicine of a large community hospital. Functional status was assessed shortly before discharge using the Timed Up and Go test performed twice in a standard way by trained physiotherapists and was defined as a test duration ≥15 s. Sensitivity analyses using a cut-off at >10 and >20 s were performed.Primary and secondary outcome measuresThe primary and secondary outcome measures were unplanned readmission and death, respectively, within 6 months after discharge.ResultsWithin 6 months after discharge, 107/338 (31.7%) patients had an unplanned readmission and 31/338 (9.2%) died. Functional impairment was associated with higher risk of death (OR 2.44, 95% CI 1.15 to 5.18), but not with unplanned readmission (OR 1.34, 95% CI 0.84 to 2.15). No significant association was found between functional impairment and the total number of unplanned readmissions (adjusted OR 1.59, 95% CI 0.95 to 2.67).ConclusionsFunctional impairment at discharge of an acute medical hospitalisation was associated with higher risk of death, but not of unplanned readmission within 6 months after discharge. Simple performance-based assessment may represent a better prognostic measure for mortality than for readmission.

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“… 29 Furthermore, a physiotherapist is not absolutely needed, as it can be performed by nursing personal as well. 46 47 …”

Section: Discussionmentioning

confidence: 99%

Performance-based functional impairment and readmission and death: a prospective study

et al. 2017

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Hospice and End of Life

Mueller¹,

Wilson²,

Briggs³

2020

Guccione's Geriatric Physical Therapy

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Physical Therapists’ Contribution to the Hospice and Palliative Care Interdisciplinary Team

Wilson¹,

Mueller

Briggs

2017

J Hosp Palliat Nurs

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There is mounting evidence of the physical therapist’s role in hospice and palliative care (HPC) for optimizing quality of life and engagement in remaining life activities. The purpose of this clinical summary is to describe the variety of roles and clinical approaches that physical therapists are able to contribute to the care of patients with a life-threatening or terminal illness. In addition, culture, religion, and individual patient/family preferences tend to be contributing factors as they relate to physical therapy (PT) in HPC. Physical therapists have multiple practice patterns that they can use in HPC for a variety of clinical signs and symptoms, patient situations, and disease trajectories. Access to PT services is inconsistent and often depends on the understanding of the role of PT within HPC. In addition, providers must acknowledge varying levels of acceptance and integration of PT and HPC based on individual and contextual factors. In order to optimize remaining quality of life and optimize care and safety, PT and HPC should be integrated in a collaborative, prospective manner, and PT should be closely integrated with the entire interdisciplinary HPC care team.

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Functional Assessment and Intervention by Nursing Assistants in Hospice and Palliative Care Inpatient Care Settings

Cited by 3 publications

References 23 publications

Performance-based functional impairment and readmission and death: a prospective study

Performance-based functional impairment and readmission and death: a prospective study

Hospice and End of Life

Physical Therapists’ Contribution to the Hospice and Palliative Care Interdisciplinary Team

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