Care at Home Lessens Risk of Hospital Re-Admission within 30 Days Following Hospitalization for Heart Failure

Journal of the American Geriatrics Society Research Summary

Older adults who are recovering from heart failure often leave the hospital to stay at rehabilitation facilities (also called skilled nursing facilities) before they return home. However, healthcare practitioners know that the stress of the transitioning from hospital to skilled nursing facility and back to a person’s home can result in an older adult’s readmission to the hospital within 30 days after their discharge.

For that reason, older adults who have heart failure may do better when they get home health care once they return home after their discharges from the hospital and skilled nursing facility.

To learn more, a team of researchers studied the association between hospital readmission risk and receiving home health care after leaving skilled nursing facilities. To do so, they examined the records of Medicare patients, aged 65 and older, who had returned home from skilled nursing facilities following hospitalization for heart failure. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Dementia Increases the Risk of 30-Day Readmission to the Hospital After Discharge

Journal of the American Geriatrics Society Research Summary

About 25 percent of older adults admitted to hospitals have dementia and are at increased risk for serious problems like in-hospital falls and delirium (the medical term for an abrupt, rapid change in mental function). As a result, older adults with dementia are more likely to do poorly during hospital stays compared to older adults without dementia.

Until now, little was known about the effects of dementia on early hospital readmission. Researchers in Japan recently published the results of a study to learn more about the effects of dementia and being admitted to the hospital within 30 days of a previous hospital discharge (the medical term for leaving the hospital once your care is considered complete). Their study was published in the Journal of the American Geriatrics Society.

The researchers studied information from people 65-years-old and older who had been discharged from hospitals between 2014 and 2015, and then followed them for six months. The researchers were looking for unplanned readmissions to the hospital within 30 days of the patient’s discharge. Continue reading

Older Adults Who are Stronger and Able to Function Well Have Better Outcomes When Hospitalized with Critical Illnesses

JAGS graphicJournal of the American Geriatrics Society Research Summary

Older adults are more likely than younger adults to develop critical illnesses that require hospitalization and intensive care. These illnesses include severe pneumonia and other serious respiratory conditions, congestive heart failure, heart attacks, and sepsis (a life-threatening complication from bacterial infections).

Until now, the role of strength before hospitalization has not been well-studied. Strength’s effects on how well older adults do following an intensive care unit (ICU) stay also have not been well-studied. To fill this knowledge gap, a research team created a study. The study wasto learn how older adults’ strength before they became ill affected how long they stayed in the hospital after being admitted to an ICU. They also learned whether or not the older adults died while in the hospital or within a year after discharge. Their study was published in the Journal of the American Geriatrics Society.

The researchers enrolled 575 people who had been admitted to the ICU one or more times. Participants were between the ages of 70 and 79 and lived in Memphis, TN, and Pittsburgh, PA, between March 1997 and July 1998. The participants had taken strength tests within two years before their admission to the ICU. Tests included walking 20 meters (about 64 feet), completing repeated chair stands, and assessing balance and grip strength.

The researchers learned that:

  • Participants with the slowest walk speeds had an 80 percent higher risk of dying within 30 days of their ICU admission. They had twice the risk of dying within one year of their ICU admission, compared to participants with the fastest walk speeds.
  • Participants with the poorest balance had a 77 percent higher risk of dying within 30 days of their hospital admission compared to participants with the fastest walk speeds.
  • Participants whose balance was rated as “moderate” had a 52 percent higher chance of dying within 30 days of their ICU admission.

What’s more, the researchers found that older adults who were weaker had longer hospital stays.

The researchers also noted that slower pre-hospital walk speed in particular was very strongly linked both to death and longer hospital stays.

This summary is from “The Influence of Pre-hospital Function and Strength on Outcomes of Older Critically Ill Adults.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are D. Clark Files, MD; Rebecca Neiberg, MS; Julia Rushing, MStat; Peter E. Morris, MD; Michael P. Young, MD; Hilsa Ayonayon, PhD; Tamara Harris, MD; Anne Newman, MD, MPH; Susan Rubin, MD; Eric Shiroma, MEd; Denise Houston, PhD; Michael E. Miller, PhD; and Stephen B. Kritchevsky, PhD.

Hospitalized Older Adults Released to Skilled Nursing Facilities May Not Get Counseling to Help Make Informed Choices

JAGS graphicJournal of the American Geriatrics Society Research Summary

More than 20 percent of all hospitalized older adults who use Medicare will be admitted to a skilled nursing facility following a stay in the hospital (also known as “post-acute care”). However, these men and women may be given too little information when it comes to choosing a post-acute care facility: sometimes they may receive just a list of addresses for local facilities. What’s more, hospitalized older adults typically don’t plan for care at a skilled nursing facility ahead of time. This can lead to making important decisions too quickly or during a time of particular stress.

We don’t have much information about how people select skilled nursing facilities or what information they’re given to make informed choices. So a team of researchers recently studied how hospitalized older adults make decisions about choosing a facility, who helps them decide, what they think about the process, and what they consider as they make decisions. The researchers published their study in the Journal of the American Geriatrics Society.

They interviewed 98 older adults who had just been admitted to a skilled nursing facility. In 90 interviews in five cities across the country, the researchers spoke only to the older adult. A family member participated in the other eight interviews. Continue reading