For older patients, hospitalization is a two-edged sword. While hospitalization avails older patients of the expertise of consultants and the diagnostic and therapeutic innovations of high technology, it exposes them to the adverse risks of hospitalization—iatrogenic illness, functional decline (a loss of independence in activities of daily living), and possible institutionalization. By recognizing the patient at risk for functional decline and optimizing the process of patient care, physicians gain the opportunity to minimize the adverse effects of hospitalization and improve functional outcomes. An assessment of risk factors for functional and psychosocial impairments will suggest therapeutic interventions directed at maintaining or restoring the independent functioning of older people and enhancing their chances of returning home.
KeywordsFunctional Decline Acute Hospital Comprehensive Geriatric Assessment Physical Restraint Home Health Care
Unable to display preview. Download preview PDF.
- 1.Vital and Health Statistics. Health Data on Older Americans,1992 Series 3: Analytic and Epidemiological Studies, No. 27. Publication 93–1411. Hyattsville, MD; US Dept. of Health and Human Services; 1993.Google Scholar
- 5.Narain P, Rubenstein LZ, Wieland GD, et al. Predictors of immediate and 6-month outcomes in hospitalized elderly patients: the importance of functional status./Am Geriatr Soc 1988; 36: 775–783.Google Scholar
- 6.Hirsch C, Sommers L, Olsen A, et al. The natural history of functional morbidity in hospitalized older patients./Am Geriatr Soc 1990; 38: 1296–1303.Google Scholar
- 24.National Institutes of Health Consensus Development Conference Statement: Geriatric assessment methods for clinical decision making. J Am Geriatr Soc. 1988; 36: 342–347.Google Scholar
- R.M. PalmerGoogle Scholar
- 40.Powell C, Mitchell-Pedersen L, Fingerote E, et al. Freedom from restraint: consequences of reducing physical restraints in the management of the elderly. Can Med Assoc J. 1989; 141: 561–564.Google Scholar
- 48.Solomon DH, Wagner DR, Marenberg MB, et al. Predictors of formal home health care use in elderly patients after hospitalization./Am Geriatr Soc 1993; 41: 961–966.Google Scholar