Featured Research

from universities, journals, and other organizations

Odds of rehospitalization of cognitively impaired varies by discharge destination

Date:
November 19, 2013
Source:
Indiana University
Summary:
Cognitively impaired older adults released from the hospital are less likely to be rehospitalized within 30 days if they go to a nursing home than if they return to their own home.

Cognitively impaired older adults released from the hospital are less likely to be rehospitalized within 30 days if they go to a nursing home than if they return to their own home or the home of a family member, according to an Indiana University and Regenstrief Institute study.

Discharge destination following hospitalization and cognitive status are co-dependent factors, according to the study, which followed 976 men and women, age 65 and older.

The study findings are reported in “Interaction Between Cognitive Impairment and Discharge Destination and Its Impact on Rehospitalizations,” published in the November issue of the Journal of the American Geriatrics Society.

“Why do nursing home residents who are cognitively impaired get readmitted to hospitals less often than those released to a community setting? There may be several explanations,” said study first author Arif Nazir, M.D., an assistant clinical professor of medicine at the IU School of Medicine who is on the Board of the American Medical Directors Association. "The nursing home ensures medication adherence, which can be very difficult for cognitively impaired residents who reside at home, even sometimes with support from their families.

“And at home, the physical problems of the cognitively impaired may not be recognized. These are health issues which, if known, would send them back to the hospital."

In additional to being less likely to be readmitted to the hospital than their counterparts who are discharged to the community, the study found that cognitively impaired nursing home residents are also less likely than nursing home residents with healthy brains to be readmitted to a hospital within 30 days of discharge. But the reverse is true if older adults are sent home rather than to an institution. Cognitively impaired individuals released from a hospital to a community setting are more likely to be readmitted to the hospital than those with a healthy brain.

“Patients discharged to nursing homes with Alzheimer’s disease and other cognitive impairments may be less physically ill than those who are in a nursing home because of pure physical ailments like heart failure or an infection. The cognitively impaired individuals who end up getting discharged to an institution such as a nursing home typically have social and behavioral issues which these facilities know how to handle,” Dr. Nazir said.

The study demonstrates that cognitive impairment is not independently associated with rehospitalizations and that this relationship is modified by discharge destination. The results provide unique and useful insights regarding the interaction of two important risk factors for the rehospitalization of the elderly population, mental status and the discharge destination.

In both nursing homes and in the community setting, the physical problems of the cognitively impaired may not be recognized.

“In some cases families refuse aggressive care for their loved one, but such care may be harder to do when the older adult is living at home,” said study senior author Malaz Boustani, M.D., MPH, Regenstrief Investigator, associate professor of medicine at the IU School of Medicine and associate director of the IU Center for Aging Research. He also directs the Healthy Aging Brain Center at Wishard-Eskenazi Health. "And when the cognitively impaired individual is being taken care of at home rather than in a facility, the family, like the family of the physically ill patient with a healthy brain, may just feel unable to handle the burden after release from the hospital."

“To our knowledge,” Dr. Nazir said, “this is the first study to investigate whether discharge destination of older adults makes a difference in rehospitalization rate. Our findings -- that it does have an effect -- is yet another factor that families and hospital administrators as well as state and national policy makers will want to take into account for many reasons.”

“The fact that odds of rehospitalization are higher if the cognitively impaired individual is sent home from the hospital rather than to a nursing home strongly suggests the importance of developing a personalized transitional care model based on the brain health of older adults as well as the severity of their medical illness,” said Dr. Boustani, the chief innovation and implementation officer at IU Health.


Story Source:

The above story is based on materials provided by Indiana University. Note: Materials may be edited for content and length.


Journal Reference:

  1. Arif Nazir, M.D. et al. Interaction Between Cognitive Impairment and Discharge Destination and Its Impact on Rehospitalizations. Journal of the American Geriatrics Society., November 2013

Cite This Page:

Indiana University. "Odds of rehospitalization of cognitively impaired varies by discharge destination." ScienceDaily. ScienceDaily, 19 November 2013. <www.sciencedaily.com/releases/2013/11/131119112405.htm>.
Indiana University. (2013, November 19). Odds of rehospitalization of cognitively impaired varies by discharge destination. ScienceDaily. Retrieved July 25, 2014 from www.sciencedaily.com/releases/2013/11/131119112405.htm
Indiana University. "Odds of rehospitalization of cognitively impaired varies by discharge destination." ScienceDaily. www.sciencedaily.com/releases/2013/11/131119112405.htm (accessed July 25, 2014).

Share This




More Health & Medicine News

Friday, July 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

AFP (July 24, 2014) A so-called drugs rehab 'clinic' is closed down in Pakistan after police find scores of ‘patients’ chained up alleging serial abuse. Duration 03:05 Video provided by AFP
Powered by NewsLook.com
Too Few Teens Receiving HPV Vaccination, CDC Says

Too Few Teens Receiving HPV Vaccination, CDC Says

Newsy (July 24, 2014) The Centers for Disease Control and Prevention is blaming doctors for the low number of children being vaccinated for HPV. Video provided by Newsy
Powered by NewsLook.com
New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

    Health News

      Environment News

        Technology News



          Save/Print:
          Share:

          Free Subscriptions


          Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

          Get Social & Mobile


          Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

          Have Feedback?


          Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
          Mobile: iPhone Android Web
          Follow: Facebook Twitter Google+
          Subscribe: RSS Feeds Email Newsletters
          Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins