Health-related outcomes of a facility-based transition care program for older adults: a prospective cohort study†
Jo-Aine Hang
A , Jacqueline Francis-Coad B * , Angela Jacques A , Nicholas Waldron C , Kate Purslowe D and Anne-Marie Hill B
+ Author Affiliations
- Author Affiliations
A Curtin School of Allied Health, Curtin University, Kent Street, Perth, WA 6102, Australia.
B School of Allied Health, WA Centre for Health & Ageing, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
C Department of Aged Care and Rehabilitation, Armadale Kelmscott Memorial Hospital, East Metropolitan Health Service, 3056 Albany Highway Mount Nasura, WA 6112, Australia.
D Amana Living Inc., 99 McCabe Street, Mosman Park, WA 6012, Australia.
* Correspondence to: jacqueline.francis-coad@uwa.edu.au
Australian Health Review 47(3) 322-330 https://doi.org/10.1071/AH22226
Submitted: 29 September 2022 Accepted: 27 February 2023 Published: 4 April 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.
Abstract
Objectives There is limited evidence regarding the effectiveness of transition care programs (TCP) in improving health-related outcomes and discharge destination for older adults. This study aimed to (i) identify changes in health-related outcomes in older adults undergoing a facility-based TCP between admission and discharge; and (ii) compare health-related outcomes between participants discharged home and those discharged to permanent residential care.
Method A prospective, observational study was conducted with older adults aged ≥60 years who participated in a facility-based TCP that provided short-term rehabilitation including mobility training, group exercise and cognitive activities. Physical, cognitive and social outcomes were measured at admission and discharge. Data were analysed using linear mixed modelling.
Results Of the 41 participants (mean age 80.1 (±8.9) years), 26 (63.4%) were discharged home compared with 14 (34.2%) to residential care. Participants showed statistically significantly improvement in performance of activities of daily living (ADL), mobility and health-related quality of life, with a statistically and clinically significant decline in performance of instrumental ADL. Participants discharged home had statistically and clinically significant greater improvement in mobility compared with those discharged to residential care (de Morton mobility index: home, 13.6 (95% CI: 9.8, 17.4) vs residential, 6.9 (95% CI: 1.7, 12.0), Pinteraction = 0.04) and statistically and clinically significant less decline in instrumental ADL (Lawton’s scale: home, −0.8 (95% CI: −1.3, −0.2) vs residential, −2.1 (95% CI: −2.9, −1.4), Pinteraction = 0.002).
Conclusion Older adults participating in a facility-based TCP had improvements in physical, cognitive and social functional abilities. However, those who returned home still had residual mobility deficits and decreased performance of instrumental ADL when compared with normative community level recommendations, which could impact on longer term community living. Further research investigating which program service components could be modified to further improve rehabilitation outcomes could benefit older adults in returning and remaining at home.
Keywords: activities of daily living, aged care, community living, functional abilities, older adult, rehabilitation, transition care program.
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