Activities of daily living and cognitive function in frail multi-diseased elderly patients ready for discharge-planning

A comparative study of patients discharged to ordinary housing or nursing homes

Objectives

To describe activities of daily living (ADL) and cognitive function in multi-diseased inpatients in an acute care medical ward ready for discharge planning. A further aim was to compare ADL and cognitive function in patients discharged to ordinary housing and nursing homes.

Design

A register- based study from an acute care medical ward (n= 147) in Örebro, Sweden. Data from medical records of in-patients were collected during a period of six months.

Methods

In-patients who were ready for discharge-planning (n=147), mean age 86 years, were assessed on one occasion by an occupational therapist. ADL were assessed using the ADL-taxonomy (six activities). Cognitive function was assessed using the MMSE (n=117).

Results

The assessments with the ADL-taxonomy showed that the frequency of patients independent in the different activities varied from 5-92 %. Most patients were independent in “Eating and Drinking”. When comparing ADL between patients who were discharged to ordinary housing (n=94) and nursing homes (n=36) there was a significant difference in five of six activities. The patients who were discharged to ordinary housing were more independent in their personal care. No statistical significance in cognitive function between the two groups was found. All correlation coefficients between ADL and cognitive function were low but statistically significant (- 0,397 and –0,538).

Conclusions

Patients discharged to ordinary housing were more independent in ADL compared to patients discharged to nursing homes. Many of the inpatients who were discharged to ordinary housing had a very low cognitive function.