Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs

BACKGROUND: two-thirds of older patients admitted as an emergency to a general hospital have co-existing mental health problems including delirium, dementia and depression. This study describes the outcomes of older adults with co-morbid mental health problems after an acute hospital admission. ME...

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Main Authors: Bradshaw, Lucy, Goldberg, Sarah E., Lewis, Sarah A., Whittamore, Kathy, Gladman, John R.F., Jones, Rob G., Harwood, Rowan H.
Format: Article
Published: Oxford University Press 2013
Online Access:https://eprints.nottingham.ac.uk/2839/
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author Bradshaw, Lucy
Goldberg, Sarah E.
Lewis, Sarah A.
Whittamore, Kathy
Gladman, John R.F.
Jones, Rob G.
Harwood, Rowan H.
author_facet Bradshaw, Lucy
Goldberg, Sarah E.
Lewis, Sarah A.
Whittamore, Kathy
Gladman, John R.F.
Jones, Rob G.
Harwood, Rowan H.
author_sort Bradshaw, Lucy
building Nottingham Research Data Repository
collection Online Access
description BACKGROUND: two-thirds of older patients admitted as an emergency to a general hospital have co-existing mental health problems including delirium, dementia and depression. This study describes the outcomes of older adults with co-morbid mental health problems after an acute hospital admission. METHODS: a follow-up study of 250 patients aged over 70 admitted to 1 of 12 wards (geriatric, medical or orthopaedic) of an English acute general hospital with a co-morbid mental health problem and followed up at 180 days. RESULTS: twenty-seven per cent did not return to their original place of residence after the hospital admission. After 180 days 31% had died, 42% had been readmitted and 24% of community residents had moved to a care home. Only 31% survived without being readmitted or moving to a care home. However, 16% spent >170 of the 180 days at home. Significant predictors for poor outcomes were co-morbidity, nutrition, cognitive function, reduction in activities of daily living ability prior to admission, behavioural and psychiatric problems and depression. Only 42% of survivors recovered to their pre-acute illness level of function. Clinically significant behavioural and psychiatric symptoms were present at follow-up in 71% of survivors with baseline cognitive impairment, and new symptoms developed frequently in this group. CONCLUSIONS: the variable, but often adverse, outcomes in this group implies a wide range of health and social care needs. Community and acute services to meet these needs should be anticipated and provided for.
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spelling nottingham-28392020-05-04T16:37:10Z https://eprints.nottingham.ac.uk/2839/ Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs Bradshaw, Lucy Goldberg, Sarah E. Lewis, Sarah A. Whittamore, Kathy Gladman, John R.F. Jones, Rob G. Harwood, Rowan H. BACKGROUND: two-thirds of older patients admitted as an emergency to a general hospital have co-existing mental health problems including delirium, dementia and depression. This study describes the outcomes of older adults with co-morbid mental health problems after an acute hospital admission. METHODS: a follow-up study of 250 patients aged over 70 admitted to 1 of 12 wards (geriatric, medical or orthopaedic) of an English acute general hospital with a co-morbid mental health problem and followed up at 180 days. RESULTS: twenty-seven per cent did not return to their original place of residence after the hospital admission. After 180 days 31% had died, 42% had been readmitted and 24% of community residents had moved to a care home. Only 31% survived without being readmitted or moving to a care home. However, 16% spent >170 of the 180 days at home. Significant predictors for poor outcomes were co-morbidity, nutrition, cognitive function, reduction in activities of daily living ability prior to admission, behavioural and psychiatric problems and depression. Only 42% of survivors recovered to their pre-acute illness level of function. Clinically significant behavioural and psychiatric symptoms were present at follow-up in 71% of survivors with baseline cognitive impairment, and new symptoms developed frequently in this group. CONCLUSIONS: the variable, but often adverse, outcomes in this group implies a wide range of health and social care needs. Community and acute services to meet these needs should be anticipated and provided for. Oxford University Press 2013-06-25 Article PeerReviewed Bradshaw, Lucy, Goldberg, Sarah E., Lewis, Sarah A., Whittamore, Kathy, Gladman, John R.F., Jones, Rob G. and Harwood, Rowan H. (2013) Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs. Age and Ageing, 42 (5). pp. 582-588. ISSN 0002-0729 http://ageing.oxfordjournals.org/content/42/5/582.long doi:10.1093/ageing/aft074 doi:10.1093/ageing/aft074
spellingShingle Bradshaw, Lucy
Goldberg, Sarah E.
Lewis, Sarah A.
Whittamore, Kathy
Gladman, John R.F.
Jones, Rob G.
Harwood, Rowan H.
Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs
title Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs
title_full Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs
title_fullStr Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs
title_full_unstemmed Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs
title_short Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs
title_sort six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs
url https://eprints.nottingham.ac.uk/2839/
https://eprints.nottingham.ac.uk/2839/
https://eprints.nottingham.ac.uk/2839/