Cognitive skills for daily decision making on admission is the most important factor associated with return to home or retirement home in a general-population low intensity rehab programme.
Source: PubMed, NCBI / U.S. National Library of Medicine
As a person ages and accumulates medical morbidities, their ability to participate in traditional high-intensity rehabilitation programmes following an acute medical event may be not be feasible. Low-intensity rehabilitation (LIR) is an emerging approach to restoring function in older persons; however few predictors for which individuals will benefit from LIR are available. Retrospective cohort study evaluating predictors for discharge from an inpatient LIR programme to home or retirement home (home/RH) and length of stay (LoS) using the Minimum Data Set (MDS) on admission. 1662 admissions were included, of which 910 (54.8%) were discharged to home/RH, whilst 752 (45.2%) followed a long-term care (LTC) trajectory. Factors associated with discharge to home/RH included age (β = 0.033, P < .001), weight (β = -0.013, P < .001), rehabilitation intensity (β = <0.001, P < .001), LoS (β = -0.011, P < .001), cognition (β = 0.546, P < .001) and activities of daily living (P < .01). Factors associated with LoS included weight (Spearman coefficient 0.124, P < .001), rehabilitation intensity (0.895, P < .001), and ADLs (except bathing and toileting; P ≤ .001). After correcting for these factors, cognition had the largest adjusted odds ratio for home/RH dischar
Abstract
As a person ages and accumulates medical morbidities, their ability to participate in traditional high-intensity rehabilitation programmes following an acute medical event may be not be feasible. Low-intensity rehabilitation (LIR) is an emerging approach to restoring function in older persons; however few predictors for which individuals will benefit from LIR are available. Retrospective cohort study evaluating predictors for discharge from an inpatient LIR programme to home or retirement home (home/RH) and length of stay (LoS) using the Minimum Data Set (MDS) on admission. 1662 admissions were included, of which 910 (54.8%) were discharged to home/RH, whilst 752 (45.2%) followed a long-term care (LTC) trajectory. Factors associated with discharge to home/RH included age (β = 0.033, P < .001), weight (β = -0.013, P < .001), rehabilitation intensity (β = <0.001, P < .001), LoS (β = -0.011, P < .001), cognition (β = 0.546, P < .001) and activities of daily living (P < .01). Factors associated with LoS included weight (Spearman coefficient 0.124, P < .001), rehabilitation intensity (0.895, P < .001), and ADLs (except bathing and toileting; P ≤ .001). After correcting for these factors, cognition had the largest adjusted odds ratio for home/RH discharge (1.455, 95% confidence interval 1.209, 1.751), with 68.3% of LIR participants with the highest cognitive score returning to home/RH, versus 12.5% with the lowest. Using the commonly available MDS dataset, this study identified cognition as the most important predictive factor for discharge to home/RH. Age, mobility and continence on admission were also predictive. As the population ages and the applicability of LIR increases, these factors may be helpful in determining which individuals benefit most from LIR.