Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-09T12:41:31.405Z Has data issue: false hasContentIssue false

An intermediate care unit for older people with both physical and psychiatric disorders: naturalistic outcome study

Published online by Cambridge University Press:  22 February 2013

Claire Hilton*
Affiliation:
Central and North West London NHS Foundation Trust, Older People and Health Ageing Service Line, Bentley House, 15-21 Headstone Drive, Harrow HA3 5QX, UK
Andrew Madaras
Affiliation:
Central and North West London NHS Foundation Trust, Older People and Health Ageing Service Line, Bentley House, 15-21 Headstone Drive, Harrow HA3 5QX, UK
Maria Qureshi
Affiliation:
Central and North West London NHS Foundation Trust, Older People and Health Ageing Service Line, Bentley House, 15-21 Headstone Drive, Harrow HA3 5QX, UK
*
Correspondence should be addressed to: Claire Hilton, Consultant Psychiatrist, Central and North West London NHS Foundation Trust, Older People and Health Ageing Service Line, Bentley House, 15-21 Headstone Drive, Harrow HA3 5QX, UK. Phone: +0208-424-7715; Fax: +0208-424-7773. Email: [email protected].

Abstract

Background: An intermediate care unit opened in 2008 aiming to relieve pressure on beds in the local general hospital. Its goal was to provide rehabilitation for people recovering from physical illness who had coexisting psychiatric symptoms, including from delirium, but for whom assessment suggested that discharge home might be achieved. As an experimental unit, it warranted evaluation. We aimed to identify clinical factors associated with higher rates of discharge of the patients to their own homes.

Methods: A naturalistic retrospective exploratory cohort study of 100 consecutive admissions to the intermediate care unit. A backward logistic regression analysis was performed.

Results: Discharge home was associated with better scores on the Barthel Index of Activities of Daily Living at the time of discharge, a shorter duration of stay, and a psychiatric diagnosis other than delirium.

Conclusions: At the time of pre-admission assessment, clinical factors which were likely to predict discharge home were unclear, suggesting a need for further studies to determine who might best benefit from this sort of intermediate care placement.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adamis, D., Treloar, A., Martin, F. and Macdonald, A. (2006). Recovery and outcome of delirium in elderly medical inpatients. Archives of Gerontology and Geriatrics, 4, 289298.CrossRefGoogle Scholar
Alzheimer's Society (2009). Counting the Cost: Caring for People with Dementia on Hospital Wards. Available at: http://alzheimers.org.uk/site/scripts/download_info.php?downloadID=356; last accessed 3 February 2013.Google Scholar
Barthel, D. and Mahoney, F. (1965). Functional evaluation of the Barthel Index. Maryland State Medical Journal, 14, 6165.Google Scholar
Burns, A.et al. (1999). Health of the Nation Outcome Scales for elderly people (HoNOS 65+). British Journal of Psychiatry, 174, 424427.CrossRefGoogle ScholarPubMed
Department of Health (2001). National Service Framework for Older People. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/. . ./DH_4003066.Google Scholar
Department of Health (2009). Living Well with Dementia: a National Dementia Strategy. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_094058.Google Scholar
Department of Health (2011). Living Well with Dementia: a National Dementia Strategy: Good Practice Compendium – an Assets Approach. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_123476.Google Scholar
Enders, C. K. (2010). Applied Missing Data Analysis. New York: Guilford Press.Google Scholar
George, J., Bleasdale, S. and Singleton, S. J. (1997). Causes and prognosis of delirium in elderly patients admitted to a district general hospital. Age and Ageing, 26, 423427.CrossRefGoogle ScholarPubMed
George, J., Adamson, J. and Woodford, H. (2011). Joint geriatric and psychiatric wards: a review of the literature. Age and Ageing, 40, 543548.CrossRefGoogle ScholarPubMed
Hodkinson, H. M. (1972). Evaluation of a mental test score for assessment of mental impairment in the elderly. Age and Ageing, 1, 233238.CrossRefGoogle ScholarPubMed
Holmes, J. and House, A. (2000). Psychiatric illness predicts poor outcome after surgery for hip fracture: a prospective cohort study. Psychological Medicine, 30, 921929.CrossRefGoogle ScholarPubMed
Madaras, A. and Hilton, C. (2010). The Greenview intermediate care unit for people with both mental and physical illnesses. Nursing Times, 106, 1819.Google ScholarPubMed
McAvary, G.et al. (2006). Older adults discharged from the hospital with delirium: 1-year outcomes. Journal of the American Geriatrics Society, 54, 12451250.CrossRefGoogle Scholar
National Research Ethics Service (2009). Defining Research. Available at: http://www.nres.nhs.uk/applications/is-your-project-research/.Google Scholar
Royal College of Physicians (2012). Hospitals on the Edge? The Time for Action. Available at: http://www.rcplondon.ac.uk/sites/default/files/documents/hospitals-on-the-edge-report.pdf.Google Scholar
World Health Organisation (2010). International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Available at: http://apps.who.int/classifications/icd10/browse/2010/en.Google Scholar