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Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs

Bradshaw, Lucy; Goldberg, Sarah E.; Lewis, Sarah A.; Whittamore, Kathy; Gladman, John R.F.; Jones, Rob G.; Harwood, Rowan H.

Authors

Lucy Bradshaw lucy.bradshaw@nottingham.ac.uk

Sarah E. Goldberg

Sarah A. Lewis

Kathy Whittamore

John R.F. Gladman

Rob G. Jones

Rowan H. Harwood

Abstract

BACKGROUND:
two-thirds of older patients admitted as an emergency to a general hospital have co-existing mental health problems including delirium, dementia and depression. This study describes the outcomes of older adults with co-morbid mental health problems after an acute hospital admission.
METHODS:
a follow-up study of 250 patients aged over 70 admitted to 1 of 12 wards (geriatric, medical or orthopaedic) of an English acute general hospital with a co-morbid mental health problem and followed up at 180 days.
RESULTS:
twenty-seven per cent did not return to their original place of residence after the hospital admission. After 180 days 31% had died, 42% had been readmitted and 24% of community residents had moved to a care home. Only 31% survived without being readmitted or moving to a care home. However, 16% spent >170 of the 180 days at home. Significant predictors for poor outcomes were co-morbidity, nutrition, cognitive function, reduction in activities of daily living ability prior to admission, behavioural and psychiatric problems and depression. Only 42% of survivors recovered to their pre-acute illness level of function. Clinically significant behavioural and psychiatric symptoms were present at follow-up in 71% of survivors with baseline cognitive impairment, and new symptoms developed frequently in this group.
CONCLUSIONS:
the variable, but often adverse, outcomes in this group implies a wide range of health and social care needs. Community and acute services to meet these needs should be anticipated and provided for.

Journal Article Type Article
Publication Date Jun 25, 2013
Journal Age and Ageing
Print ISSN 0002-0729
Electronic ISSN 0002-0729
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 42
Issue 5
Institution Citation Bradshaw, L., Goldberg, S. E., Lewis, S. A., Whittamore, K., Gladman, J. R., Jones, R. G., & Harwood, R. H. (2013). Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs. Age and Ageing, 42(5), doi:10.1093/ageing/aft074
DOI https://doi.org/10.1093/ageing/aft074
Publisher URL http://ageing.oxfordjournals.org/content/42/5/582.long
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0




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