059Rehabilitation for Acutely Unwell Older Patients: How Well Does it Work?

Abstract

Background: Rehabilitation in older people can be a challenge in terms of its impact on their over-all health, nursing home (NH) admission, hospital readmissions and mortality. This study aims to evaluate the rehabilitation outcome for older patients admitted in a rehabilitation unit in Munster. Methods: Retrospective study of patients admitted for rehabilitation from 01 January 2014 to 31 December 2014. Data were collected from minutes of MDT meetings, www. rip.ie and telephone conversation with patients/family, as approved by the local ethics committee. Patients were categorised into 60.79 years and ≥80 years age group. Results: 154 patients were admitted, 102 were female (66%), mean age 80.9 years (SD ± 7.5). 59% (n = 91) were ≥80 years. Over-all median length of stay (LOS) was 18 days (IQR 14,27). Orthopaedic patients had the shortest LOS (18 days) and stroke patients, the longest (22.5 days). Hospital was the main source of admission (85%, n = 131). On admission, median MMSE and mean Barthel Index (BI) were higher in 60.79 years than in ≥80 years, 28 (IQR 22,29) vs 24 (IQR 18,28) (p = 0.002) and 11.5 (SD ± 4.3) vs 10.5 (SD ± 3.3) (p = 0.124), respectively, while mean FRASE was higher in ≥80 years 12.3 (SD ± 2.6) vs 10.8 (SD ± 3.4), (p = 0.004). Immediately after rehabilitation, 82% (n = 126) went home, 10% (n = 15) were transferred to NH, and 8% (n = 13) to hospital. After twenty-seven months, 77% (n = 84) of the living cohort remain at home. 54 (64%) mobilise independently. 4% (n = 2) of 60.79 years are in long-term care. Conclusion: In this cohort, rehabilitation has had beneficial impact on older people's discharge destination, mobility and mortality. Further study comparing MMSE, BI, FRASE and frailty index on admission, immediately after and 2 years following discharge from the rehabilitation unit is recommended, the result of which may serve as basis in considering increase of rehabilitation beds in the unit.