This study examined a population-based profile of older adults with acquired brain injury, and their functional outcomes, in in-patient rehabilitation. Older adults aged 65 and older admitted to in-patient rehabilitation from acute care with traumatic brain injury (TBI) (n = 1214) or non-traumatic brain injury (nTBI) (n = 1,530) from 2003/04 to 2009/10 in Ontario were identified. Demographic and clinical characteristics and the total function score from the FIM(TM) Instrument were examined. The Discharge Abstract Database and National Rehabilitation Reporting System were used. Results indicated that older adults with TBI had significantly higher total function scores than those with nTBI at admission and at discharge (p < .001). However, both groups made significant (p < .001) and similar gains (p > .05) in total function scores. We conclude that older adults with TBI and nTBI make similar in-patient rehabilitation gains. Lower initial functional ability of nTBI patients on admission and patients’ different clinical profiles have implications for clinical care and resources.

Frail older patients suffer from multiple, complex needs that often go unmet in an acute care setting. Failure to recognize the geriatric giants in frail older adults is resulting in the misclassification of this population. This study investigated “sub-acute” frail, older-adult in-patients in a tertiary care teaching hospital. Although identified as being no longer acutely ill, all participants (n = 62) required active medical and/or nursing care. Frail older patients, often acutely ill, were being misclassified as sub-acute when the acuity of their illness went unrecognized which resulted in equally unrecognized disease presentations. The majority of participants wished to be cared for at or closer to home. The lack of post-acute-care service within our health care system and risk aversion on the part of hospital staff resulted in lengthy hospital stays and/or in patients being funneled into existing services (nursing homes) against their desire to go home.

Cette étude a examiné un échantillon de 228 personnes âgées en réhabilitation après chirurgie pour remplacement d’une articulation; elle a porté sur la relation entre une adaptation proactive, l’humeur et les résultats psychologiques et fonctionnels. Faire face proactivement c’est une façon de réagir qui est axée sur les objectifs et nécessite qu’on affront les facteurs qui incitent le stress comme un défi plutôt qu’une menace. Selon notre hypothèse, les personnes âgées qui adoptent des stratégies proactives d’adaptation subiraient une amélioration du fonctionnement physique et psychologique apres la réadaptation et connaîtraient une humeur positive. Le modèle proposé a trouvé du support, par lequel une expérience de vigueur a été trouvé à la médiation de l’effet d’une adaptation proactive sur les résultats. Les implications théoriques et pratiques des résultats de recherche sont discutées dans le contexte des interventions qui encourageraient les personnes âgées à faire face proactivement.