AAR  Vol.3 No.3 , July 2014
Addressing Healthcare Needs in Older People after Discharge
ABSTRACT

Healthcare needs should be addressed even when patients return home. The purpose of this study was to support a multidimensional assessment upon discharge to plan domiciliary care. Materials and Methods: This is a multicentre cross-sectional study that uses the Geriatric Functional Assessment questionnaire to assess healthcare needs. The questionnaire was administered upon discharge to 358 people aged over 65. Results: About 20% of our sample required healthcare support after discharge and 32% needed some sort of supervision. Most of the healthcare requirements involved socio-economic needs, neurological diseases, and inability to autonomously perform instrumental activities of daily living. Discussion: It is crucial to have an optimal discharge plan for older inpatients. Nurses play a key role in managing the care continuum process, and they have the instruments to select those requiring “supported discharge”, and collaborate with district nurses who can arrange healthcare interventions jointly with other professionals. They can facilitate access to resources, medical devices and aids required to restore patient autonomy.


Cite this paper
Proietti, M. , Compagnone, T. and Liotta, G. (2014) Addressing Healthcare Needs in Older People after Discharge. Advances in Aging Research, 3, 257-264. doi: 10.4236/aar.2014.33035.
References
[1]   ISTAT (2011) Annuario Statistico Italiano 2011.

[2]   Ministero della Sanità (1992) Progetto Obiettivo “Tutela della salute degli anziani 1991-1995” a stralcio del Piano Sanitario Nazionale 1992. Roma, 31-1-1992.

[3]   Rubenstein, L.Z., Josephson, K.R., Wieland, G.D., English, P.A., Sayre, J.A. and Kane, R.L. (1984) Effectiveness of a Geriatric Evaluation Unit. A Randomized Clinical Trial. The New England Journal of Medicine, 311, 1664-1670.
http://dx.doi.org/10.1056/NEJM198412273112604

[4]   Deschodt, M., Wellens, N.I.H., Braes, T., De Vuyst, A., Boonen, S., Flamaing, J., Moons, P. and Milisen, K. (2011) Prediction of Functional Decline in Older Hospitalized Patients: A Comparative Multicenter Study of Three Screening Tools. Aging Clinical & Experimental Research, 23, 421-426.
http://dx.doi.org/10.1007/BF03325237

[5]   Hoogerduijn, J.G., Schuurmans, M.J., Duijnstee, M.S., de Rooij, S.E. and Grypdonck, M.F. (2007) A Systematic Review of Predictors and Screening Instruments to Identify Older Hospitalized Patients at Risk for Functional Decline. Journal of Clinical Nursing, 16, 46-57.
http://dx.doi.org/10.1111/j.1365-2702.2006.01579.x

[6]   Ferioli, M., Ferraresi, A. and Volpato, S. (2008) Correlati clinici della dipendenza assistenziale nei pazienti anziani ospedalizzati. Giornale italiano di Scienze infermieristiche, 3, 9-14.

[7]   Bowles, K.H., Holmes, J.H., Ratcliffe, S.J., Liberatore, M., Nydick, R. and Naylor, M.D. (2009) Factors Identified by Experts to Support Decision Making for Post Acute Referral. Nursing Research, 58, 115-122.
http://dx.doi.org/10.1097/NNR.0b013e318199b52a

[8]   Hoogerduijn, J., Buurman, B., de Rooij, S., Korevaar, J., Grobbee, D. and Schuurmans, M. (2010) ISAR-HP an Instrument Predicting Functional Decline in Older Hospitalized Patients. Journal of Clinical Nursing, 19, 1219-1225.

[9]   Grauer, H. and Birnbom, F. (1975) A Geriatric Functional Rating Scale to Determinate the Need for Institutional Care. Journal of the American Geriatrics Society, 23, 472-476.

[10]   Bartoli, A., Marazzi, M. C., Palombi, L., Mancinelli, S. and Magnano, M. (1990) La versione italiana della Scala della Funzionalità Geriatrica di H. Grauer. Prospettive Sociali e Sanitarie, 27, 4-9.

[11]   Scarcella, P., Liotta, G., Marazzi, M.C., Carbini, R. and Palombi, L. (2005) Analysis of Survival in a Sample of Elderly Patients from Ragusa, Italy on the Basis of a Primary Care Level Multidimensional Evaluation. Archives of Gerontology and Geriatrics, 40, 147-156.
http://dx.doi.org/10.1016/j.archger.2004.07.004

[12]   Liotta, G., Scarcella, P., Mancinelli, S., Palombi, L., Cancelli, A. and Marazzi, M.C. (2006) The Evaluation of Care Needs in Elderly People: The Use of Geriatric Functional Evaluation Questionnaire. Annali di Igiene, Medicina Preventiva e di Comunita, 18, 225-235.

[13]   Caplan, G., Williams, A., Daly, B. and Abraham, K.A. (2004) Randomized, Controlled Trial of Comprehensive Geriatric Assessment and Multidisciplinary Intervention after Discharge of Elderly from the Emergency Department— The DEED II STUDY. Journal of the American Geriatrics Society, 52, 1417-1423.
http://dx.doi.org/10.1111/j.1532-5415.2004.52401.x

[14]   Gill, S.S., Gibson, M. and Al-Hammadi, A. (2005) Economic Implication of Discharge of Elderly from the Emergency Department Trial Results. Journal of the American Geriatrics Society, 53, 1642.
http://dx.doi.org/10.1111/j.1532-5415.2005.53487_11.x

[15]   Ellis, G., Whitehead, M.A., O’Neill, D., Langhorne, P. and Robinson. D. (2011) Comprehensive Geriatric Assessment for Older Adults Admitted to Hospital. Online Publication Date: July 2011.
http://onlinelibrary.wiley.com/cochranelibrary/search

[16]   Buurman, B.M., Parlevliet, J.L., van Deelen, B.A.J., de Haan, R.J. and de Rooij, S.E. (2010) A Randomised Clinical Trial on a Comprehensive Geriatric Assessment and Intensive Home Follow-Up after Hospital Discharge: The Transitional Care Bridge. BMC Health Services Research, 10, 296.
http://dx.doi.org/10.1186/1472-6963-10-296

[17]   Popejoy, L.L., Moylan, K. and Galambos, C. (2009) A Review of Discharge Planning Research of Older Adults 1990-2008. Western Journal of Nursing Research, 31, 923-947.
http://dx.doi.org/10.1177/0193945909334855

[18]   Popejoy, L.L., Galambos, C., Moylan, K. and Madsen, R. (2012) Challenges to Hospital Discharge Planning for Older Adults. Clinical Nursing Research, 21, 431-449.
http://dx.doi.org/10.1177/1054773812436373

 
 
Top