title: Recommendations for a change in living situation resulting from an outpatient geriatric assessment: type, frequency and risk factors.
abstract: We analyzed the outcomes of 480 comprehensive outpatient geriatric assessments to determine the frequency of recommendations for home help or a change in residence and to determine whether simple clinical observations could predict such recommendations. Fifty-eight percent (280) of the patients received no recommendation for a change in the living situation. Of the 200 patients receiving a recommendation for a change in living situation, 97 (49%) were felt to be able to stay at home with increased in-home support and/or day care, and 51.5% (103) were advised to seek placement. After adjusting for age and gender, risk factors predicting a recommendation for change were dementia (odds-ratio = 9.98), vision deficits (odds ratio = 2.02), lower education level compared to college (odds-ratio = 1.88 high school, 1.42 for less than high school), an increasing number of medical diagnoses (odds-ratio = 1.49 per diagnosis), and a functional impairment on the Katz index (odds-ratio = 1.09). The presence of these risk factors should lead to consideration of further evaluation of the home environment in this study. We conclude that geriatric patients presenting for a comprehensive outpatient evaluation commonly need a change in home situation, though most can remain in their home, and that simple clinical observations can be helpful in screening patients for further evaluation of their home environment.
authors.affiliation: Department of Medicine, University of California, School of Medicine, San Diego, La Jolla, California 92103-1990.
authors.forename: D L
authors.initials: DL
authors.lastname: Altkorn
authors.forename: J W
authors.initials: JW
authors.lastname: Ramsdell
authors.forename: J E
authors.initials: JE
authors.lastname: Jackson
authors.forename: M
authors.initials: M
authors.lastname: Renvall
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment; D006798:Housing; D006801:Humans; D008297:Male; D008393:Marriage; D008603:Mental Health; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors