title: Characteristics of patients described as sub-acute in an acute care hospital.
abstract: Frail older patients suffer from multiple, complex needs that often go unmet in an acute care setting. Failure to recognize the geriatric giants in frail older adults is resulting in the misclassification of this population. This study investigated "sub-acute" frail, older-adult in-patients in a tertiary care teaching hospital. Although identified as being no longer acutely ill, all participants (n = 62) required active medical and/or nursing care. Frail older patients, often acutely ill, were being misclassified as sub-acute when the acuity of their illness went unrecognized which resulted in equally unrecognized disease presentations. The majority of participants wished to be cared for at or closer to home. The lack of post-acute-care service within our health care system and risk aversion on the part of hospital staff resulted in lengthy hospital stays and/or in patients being funneled into existing services (nursing homes) against their desire to go home.
authors.affiliation: School of Nursing, Dalhousie University, Halifax, NS, Canada.
authors.forename: Heather Fillmore
authors.initials: HF
authors.lastname: Elbourne
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hominick
authors.forename: Laurie
authors.initials: L
authors.lastname: Mallery
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003951:Diagnostic Errors; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged / Q000145:classification / Q000458:organization & administration*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital; D011446:Prospective Studies; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers / Q000458:organization & administration* / Q000706:statistics & numerical data