Abstract:
SIR—Most older people would choose to remain at home, and this is reflected in government strategies [1]. Institutional care in older people is associated with poorer quality of life [2, 3] and increased rates of depression, [4, 5]. In one recent New Zealand study [6], 71% of older people who moved into care regretted this decision. There have been a limited number of studies examining the prediction of care home admission for older people discharged from hospital, with most following acute medical or geriatric admissions [7–10]. All studies have identified function as a key factor. Other factors include cognition [7, 9, 10], living arrangements [7, 10] and financial circumstances [9]. The ability to recognise those at risk of adverse outcomes after discharge from hospital offers geriatricians the opportunity to recognise those at risk and arrange additional follow-up or support to maintain older people in their own homes. In our previous study [11] we retrospectively examined predictors of care home admission, in the year following a specialist geriatric admission. Function on discharge was shown to be the strongest predictor of a change in domicile. Our study was limited by retrospective design with cognition and co-morbidities not recorded. The current prospective study aims to describe precipitants of residential care admission in the year following a successful home discharge from inpatient geriatric care.