2.50
Hdl Handle:
http://hdl.handle.net/10755/160307
Type:
Presentation
Title:
Patterns of Functional Decline in Hospitalized Elderly Veterans
Abstract:
Patterns of Functional Decline in Hospitalized Elderly Veterans
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2004
Author:Wakefield, Bonnie, PhD, RN
Contact Address:Research Service, 601 Hwy. 6 West, Iowa City, IA, 52246, USA
Co-Authors:John E Holman, MA, Project Director
The purpose of this study was to characterize the natural history of functional decline in hospitalized elderly veterans to identify a subset of patients at high risk for decline. The long-term goal is to develop targeted evidence-based interventions to prevent decline. The conceptual framework was based on a model of disability using the work of Nagi (Disablement Process) and the World Health Organization. Subjects were interviewed on admission to the hospital about their ability to perform activities of daily living one month prior to admission, on admission, and 4 days following admission using self-reported Functional Independence Measure (FIM) scores. The sample included 71 male medical inpatients with a mean age 75.2 (+5.6) years. The majority of patients were admitted from home (83%), married (67%) and returned to home following discharge (95%). Admission MMSE scores were low (24.8+4.1) on average, and 27% (n=19) scored 23 or less. Admission NEECHAM scores (a measure of acute confusion) were normal (27.7+2.1) on average, but 20% of subjects had early or mild confusion (n=6) or were at risk for developing confusion (n=8). Average FIM scores declined from 87.5 to 80.1 in the month preceding admission, with 75% of patients experienced physical functional decline by admission. On average, FIM scores improved during hospitalization, but 50% of patients actually declined during hospitalization. Almost half of the subjects (45%) declined on the NEECHAM during hospital stay. Admission lab data are consistent with chronically ill frail older subjects: 38% had a low albumin; 60% a low hemoglobin; 64% a low hematocrit; 48% a high BUN; and 46% a high creatinine. There is a subset of patients who experience functional decline with acute illness from which they do not recover. Furthermore, there is considerable individual variability that must be addressed when designing intervention protocols to prevent and treat functional decline.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePatterns of Functional Decline in Hospitalized Elderly Veteransen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160307-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Patterns of Functional Decline in Hospitalized Elderly Veterans</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Wakefield, Bonnie, PhD, RN</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Research Service, 601 Hwy. 6 West, Iowa City, IA, 52246, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">John E Holman, MA, Project Director</td></tr><tr><td colspan="2" class="item-abstract">The purpose of this study was to characterize the natural history of functional decline in hospitalized elderly veterans to identify a subset of patients at high risk for decline. The long-term goal is to develop targeted evidence-based interventions to prevent decline. The conceptual framework was based on a model of disability using the work of Nagi (Disablement Process) and the World Health Organization. Subjects were interviewed on admission to the hospital about their ability to perform activities of daily living one month prior to admission, on admission, and 4 days following admission using self-reported Functional Independence Measure (FIM) scores. The sample included 71 male medical inpatients with a mean age 75.2 (+5.6) years. The majority of patients were admitted from home (83%), married (67%) and returned to home following discharge (95%). Admission MMSE scores were low (24.8+4.1) on average, and 27% (n=19) scored 23 or less. Admission NEECHAM scores (a measure of acute confusion) were normal (27.7+2.1) on average, but 20% of subjects had early or mild confusion (n=6) or were at risk for developing confusion (n=8). Average FIM scores declined from 87.5 to 80.1 in the month preceding admission, with 75% of patients experienced physical functional decline by admission. On average, FIM scores improved during hospitalization, but 50% of patients actually declined during hospitalization. Almost half of the subjects (45%) declined on the NEECHAM during hospital stay. Admission lab data are consistent with chronically ill frail older subjects: 38% had a low albumin; 60% a low hemoglobin; 64% a low hematocrit; 48% a high BUN; and 46% a high creatinine. There is a subset of patients who experience functional decline with acute illness from which they do not recover. Furthermore, there is considerable individual variability that must be addressed when designing intervention protocols to prevent and treat functional decline.</td></tr></table>en_GB
dc.date.available2011-10-26T22:49:09Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:49:09Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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