High-Risk Elderly Patients in Acute Care Institutions: A Canadian Perspective

Abstract

Hospitalised elderly patients institutionalised for prolonged periods present a significant challenge to health professionals, but relatively few acute care hospitals provide specialised programmes designed to address their unique and individual needs. This article presents a review of relevant from 1978 to the present related to the needs of high-risk elderly patients in acute care institutions and comments on hypothesis versus reality. The literature indicates that when an active team approach is used with the elderly patient, focusing on rehabilitation and activities of daily living, a decreased length of stay can result. However, no studies were found that tested the results of a dynamic ‘enriched programme of care’. After a review of inpatient data on two acute orthopaedic wards at two Ontario medical centres, the authors set out to establish if it was feasible to conduct a pilot study. The proposed study included a detailed outline of an enriched programme of care utilising the resources of occupational therapists, ward nursing staff and volunteers. Over a period of 6 months there were several multidisciplinary of health professionals and volunteers, who reviewed the demographics of this population which indicated that acute elderly orthopaedic patients over 65 are being discharged fairty quickly from hospital. This reality appears to contradict the literature which suggests that this group of patients are hospitalised for long periods and therefore require more functionally focused physical rehabilitation orientated programmes. It also begs the important question regarding adequate preparation of this population for return home and continuity of care between hospital and community.