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Improved functional ability and independence in activities of daily living for older adults at high risk of hospital readmission : a randomised controlled trial

Courtney, Mary D., Edwards, Helen E., Chang, Anne M., Parker, Anthony W., Finlayson, Kathleen J., Bradbury, Carolyn , & Nielsen, Zoe (2012) Improved functional ability and independence in activities of daily living for older adults at high risk of hospital readmission : a randomised controlled trial. Journal of Evaluation In Clinical Practice, 18(1), pp. 128-134.

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    Abstract

    Objective: During hospitalisation older people often experience functional decline which impacts on their future independence. The objective of this study was to evaluate a multifaceted transitional care intervention including home-based exercise strategies for at-risk older people on functional status, independence in activities of daily living, and walking ability. Methods: A randomised controlled trial was undertaken in a metropolitan hospital in Australia with 128 patients (64 intervention, 64 control) aged over 65 years with an acute medical admission and at least one risk factor for hospital readmission. The intervention group received an individually tailored program for exercise and follow-up care which was commenced in hospital and included regular visits in hospital by a physiotherapist and a Registered Nurse, a home visit following discharge, and regular telephone follow-up for 24 weeks following discharge. The program was designed to improve health promoting behaviours, strength, stability, endurance and mobility. Data were collected at baseline, then 4, 12 and 24 weeks following discharge using the Index of Activities of Daily Living (ADL), Instrumental Index of Activities of Daily Living (IADL), and the Walking Impairment Questionnaire (Modified). Results: Significant improvements were found in the intervention group in IADL scores (p<.001), ADL scores (p<.001), and WIQ scale scores (p<.001) in comparison to the control group. The greatest improvements were found in the first four weeks following discharge. Conclusions: Early introduction of a transitional model of care incorporating a tailored exercise program and regular telephone follow-up for hospitalised at-risk older adults can improve independence and functional ability.

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    1 citations in Web of Science®

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    ID Code: 34380
    Item Type: Journal Article
    Keywords: hospital readmission, older adults, transitional care, exercise
    DOI: 10.1111/j.1365-2753.2010.01547.x
    ISSN: 1356-1294
    Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Geriatrics and Gerontology (110308)
    Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Tertiary (Rehabilitative) (111004)
    Divisions: Current > QUT Faculties and Divisions > Faculty of Health
    Current > Institutes > Institute of Health and Biomedical Innovation
    Past > Institutes > Institute for Sustainable Resources
    Current > Schools > School of Exercise & Nutrition Sciences
    Current > Schools > School of Nursing
    Copyright Owner: Copyright 2011 Blackwell Publishing Ltd
    Deposited On: 08 Sep 2010 11:29
    Last Modified: 15 Feb 2013 11:02

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