Rehabilitation of the elderly - influence of age, sex, main diagnosis and activities of daily living (ADL) on the elderly patients' return to their previous living conditions.
In geriatric rehabilitation, discharge to the living conditions in which elderly patients lived before admission is one of the most important treatment goals. The objective of this study therefore was to determine the extent to which this criterion was influenced by age, sex, main diagnosis and activities of daily living. For that purpose the results of 1845 patients, admitted consecutively from 1993 to 1995 were analysed. With advancing age an increasing number of patients was unable to return to their previous living conditions (10% vs. 24% comparing the age groups '64 years and younger' versus '85 years and older'). This age-associated decline was present for both sexes and for several diagnosis groups. A low (0-40 points) ADL-score on admission was found to be associated with a significantly smaller percentage of patients returning home (75%) than a high (90-135 points) score (95%). The criteria sex and main diagnosis were not significantly linked with the return home. According to multiple regression analysis, ADL-score on admission was the only parameter found to be significantly associated with return to preadmission living conditions, but not age. But if the ADL-score at discharge was added to the regression analysis, this criterion proved to be the only predictor. Despite the negative correlations between age as well as ADL-score on admission with return home and due to the fact that nearly three quarters of the oldest patients and of those most severely impaired on admission were able to return to their previous living conditions it seems worthwhile not to exclude patients only because of their age or the initial degree of dependence on care alone from rehabilitation services.
Hager
K
K
Clinic for Medical Rehabilitation and Geriatrics, Henriettenfoundation, Schwemannstrasse 19, D-30559 Hannover, Germany.
Nennmann
U
U