Factors related to care home admission in the year following hospitalisation in frail older adults

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.