New disabilities are common among older people after hospitalization

Older adults often face new disabilities after a hospital stay for a serious illness. Among the problems they may need to adjust to are difficulties with bathing and dressing, shopping and preparing meals, and getting around inside and outside the home. These new disabilities can lead to being hospitalized again, being placed in a nursing home, and more permanent declines in well-being. The longer a serious disability lasts, the worse it can be for an older adult.

To learn more about this issue, a research team studied information about a particular group of people. They looked at individuals who were hospitalized for a medical issue but did not require critical care. The study was based on data from the Precipitating Events Project (PEP), an ongoing study of 754 people, aged 70 or older, who lived at home at the beginning of the study. At that time, the participants were not disabled and did not need assistance in four basic activities: bathing, dressing, walking inside the house, and getting out of a chair. The researchers published their study in the Journal of the American Geriatrics Society.

The participants were examined at home at the start of the PEP study and then again every 18 months, while telephone interviews were completed monthly through June 2016.

In all, 515 participants were included in the study. They were mostly around 83 years of age and had a medical hospitalization. The participants shared medical problems related to their age, living alone, and having little social support.

At months one and six after hospitalization, disability was common for study participants and interfered with their ability to leave home for medical care. Disabilities included being unable to get dressed, walk across a room, get in or out of a chair, walk a quarter-mile, climb a flight of stairs, and drive a car.

Disability at months one and six after hospitalization was also common for the kinds of activities people need to take care of themselves, including meal preparation and taking medications.

Of the people in the study, many had new disabilities after hospitalization:

  • 31 percent were newly unable to bathe themselves
  • 42 percent couldn't do simple housework
  • 30 percent had problems taking their medications
  • 43 percent were unable to walk a quarter-mile

For those who did recover from a disability, it took between one to two months following hospitalization. Recovering also appears to have a connection to being able to perform most daily tasks, except driving. Recovering the ability to drive following a hospitalization was less common.

In many cases, recovery was incomplete even six months after hospital discharge. For example, the proportion of people who were not disabled at six months was just 65 percent for bathing, 65 percent for meal preparation, 58 percent for taking medications, and 55 percent for driving.

The research team concluded that many older adults discharged from the hospital after a serious medical illness are disabled in specific activities important for leaving the home to access care and self-manage their health conditions. They also noted that these disabilities are often new following hospitalization. Recovery from disability is frequently incomplete six months after discharge, even among persons who return home in the month after hospitalization.

Source:
Journal reference:

Dharmarajan, K., et al. (2020) Disability and Recovery After Hospitalization for Medical Illness Among Community‐Living Older Persons: A Prospective Cohort Study. Journal of the American Geriatrics Society. doi.org/10.1111/jgs.16350.

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