Older Adults and Rates of Recovery after Hospitalization
By Richard Shank
Researchers at the University of Alabama at Birmingham recently found that older adults are significantly more likely to recover from hospitalization caused by surgery than hospitalization caused by illness.
Hospitalizations result in a loss of independence in about a third of older adults. This study was designed to assess the impact of hospitalization on the activities of daily living (ADLs) of hospitalized older adults, and to compare the findings to ADLs after surgical and nonsurgical hospitalizations.
In order to assess ADLs, the researchers utilized a study of Aging Life-Space Assessment (LSA) from the University of Alabama at Birmingham. The LSA is a tool that assesses everyday physical mobility and participation in social life by incorporating measurements of where a person travels, the frequency, and the equipment or help they received to get there.
The LSA scores were similar on average for patients entering hospitals for either surgical or non-surgical reasons. Both groups experienced drops in their LSA scores immediately after discharge, with surgical patients experiencing the biggest decrease. Despite this loss, surgical patients recovered more rapidly over time. This means that those entering hospitals for non-surgical procedures are at a greater risk of recovering after treatment.
The reasons for this may include physical health, treatment complications, and negative expectations about recovery. Non-surgical patients, especially those with heart disease or pneumonia, often have comorbid conditions that make full functional recovery more difficult.
Furthermore, prolonged hospital stays often involve increased pharmaceutical treatments which can have unintended consequences that reduce the motivation to stay physically independent and/or produce a feeling of powerlessness. Finally, doctors, patients, and family often have negative expectations about recovery related to hospitalizations for chronic illness. These negative expectations can add to the post-hospitalization recovery period for those with chronic diseases.
The researchers believe that more research and planning needs to be done in order to combat the decline in physical independence that older adults experience after hospitalizations related to chronic disease.
Source: Brown, C., Roth, D., Allman, R., Sawyer, P., Ritchie, C., Roseman, J. 2009. Trajectories of life-space mobility after hospitalization. Annals of Internal Medicine 150(6): 372-380.
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