Elderly experiencing acute functional decline in hospital: Cross-disciplinary intervention at Taichung Veterans General Hospital proves effective in slowing down decline
2023.11.28 Elderly experiencing acute functional decline in hospital: Cross-disciplinary intervention at Taichung Veterans General Hospital proves effective in slowing down decline
After falling ill and being hospitalized, the physical and functional abilities of the elderly often decline significantly, with even basic self-care abilities being lost. Taichung Veterans General Hospital now points out that this is a phenomenon of acute functional decline, most likely caused by debilitation. However, with early detection and cross-disciplinary intervention, it is possible to slow down the pace of patient disability, seizing the golden opportunity for rehabilitation.
Taichung Veterans General Hospital cites the case of an 84-year-old female patient who, following a severe back pain resulting from a fall, could initially handle her daily activities independently. However, by the 5th day of hospitalization, her daily life capability had dropped from an initial score of 75 to 35, rendering her unable to care for herself.
Utilizing the "Comprehensive Geriatric Assessment," the hospital's geriatric team not only identified severe debilitation in the patient but also issues such as malnutrition, frequent urination, and severe pain. Through active pain management and the intervention of nutritionists and rehabilitation therapists, the patient showed a significant increase in activity frequency before discharge.
Nearly 50% of elderly individuals admitted to hospitals exhibit signs of debilitation. Disease-induced malnutrition and a decrease in physical activity can exacerbate pre-existing frailty issues, even leading to disability. However, research indicates that interventions such as nutrition and rehabilitation aimed at reversing debilitation can significantly reduce emergency room visits, readmissions, and mortality rates within three months.
Taichung Veterans General Hospital emphasizes its commitment to cross-professional integration through a standardized process for "hospitalized elderly debilitated patients." Within the first three days of hospitalization, the geriatric team completes a debilitation assessment and, based on recommendations from rehabilitation therapists and nutritionists, formulates an "individualized rehabilitation plan." Upon identifying patients with rehabilitation potential, active inquiries are made to determine their willingness to accept acute post-acute care, facilitating coordination and contact with transferring hospitals to seize the golden period for rehabilitation.
According to statistical data, Taichung Veterans General Hospital's integrated care ward for the elderly admitted and treated 1,261 cases of hospitalized elderly debilitated patients. Among them, 659 were male (47.7%), 602 were female (52.3%), with an average age of 82.6±9.2 years, and an average hospitalization period of 11.9±9.2 days. Following cross-team integrated care interventions, there was a significant improvement in the overall daily life activities and nutrition aspects of the patients.
Source material: https://udn.com/news/story/7266/7594291