A randomized trial of care in a hospital medical unit especially designed to improve the functional outcomes of acutely ill order patients.
Older persons who are hospitalized for acute illnesses often lose their independence and are discharged to institutions for long-term care.
We studied 651 patients 70 years of age or older who were admitted for general medical care at a teaching hospital ; these patients were randomly assigned to receive usual care or to be cared for in a special unit designed to help older persons maintain or achieve independence in self-care activities.
The key elements of this program were a specially prepared environment (with, for example, uncluttered hallways, large clocks and calendars, and handrails) ; patient-centered care emphasizing independence, including specific protocols for prevention of disability and for rehabilitation ; discharge planning with the goal of returning the patient to his or her home ; and intensive review of medical care to minimize the adverse effects of procedures and medications.
The main outcome we measured was the change from admission to discharge in the number of five basic activities of daily living (bathing, getting dressed, using the toilet, moving from a bed to a chair, and eating) that the patient could perform independently.
Twenty-four patients in each group died in the hospital.
In the usualcare group, 40 (13 percent) of the 300 surviving patients were classified as much better, 33 (11 percent) as better, 163 (54 percent) as unchanged, 39 (13 percent) as worse, and 25 (8 percent) as much worse (P=0.009).
Mots-clés Pascal : Evaluation, Soin, Service hospitalier, Réadaptation physique, Fonctionnelle, Maladie, Grave, Etablissement troisième âge, Synthèse bibliographique, Vieillard, Homme, Gérontologie
Mots-clés Pascal anglais : Evaluation, Care, Hospital ward, Physical rehabilitation, Functional, Disease, Severe, Homes for the aged, Bibliographic survey, Elderly, Human, Gerontology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0339378
Code Inist : 002B30A01C. Création : 01/03/1996.