Year: 2015
Type: dissertation
Abstract: __Abstract__ \n \nThis thesis describes the results of the evaluation of the Prevention and Reactivation Care Program (PReCaP). \nThe PReCaP is aimed at preventing functional decline among hospitalized older patients and consists of early identification of \nolder patients at risk of functional decline; and intensive follow up treatment in the hospital and if necessary in a specific rehabilitation setting after discharge \nThe PReCaP uses individualized, multidisciplinary integrated geriatric care and geriatric case management from hospital admission up to six months after hospital discharge. \n \nThe ISAR-HP, a simple questionnaire consisting of four questions can be used at hospital admission to identify older patients at risk of problems in physical and cognitive functioning, \nloneliness, lower health-related quality of life, death and higher costs of care at three and twelve months after hospital admission. \nThe PReCaP did not significantly improve independence in activities of daily living and instrumental activities of daily living compared to usual care. Four possible \nexplanations are 1) problems in development, identification and reproducing complex interventions in general; 2) local variations in context, population and elements of care \non which the intervention was based; 3) the dynamics of physical functioning; 4) the difficulty of distinguishing \nhospital-related functional decline from general functional decline among older patients. \n \nFuture evaluations of similar complex interventions among hospitalized older people should focus on the medical diagnosis in combination with reactivation domains of specific \npatient groups at higher risk, such as cardiovascular patients, and might be more successful when implemented in specialized geriatric units.
Author: Kirsten JE Asmus-Szepesi
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W118537948