[INTEGRATED APPROACH TO PREVENT FUNCTIONAL DECLINE IN HOSPITALIZED ELDERLY].
BACKGROUND
Hospital related functional decline in older patients is an underestimated problem. Thirty-five procent of 70-year old patients experience functional decline during hospital admission in comparison with pre-illness baseline. This percentage increases considerably with age.


METHODS
To address this issue, the Vlietland Ziekenhuis in The Netherlands has implemented the Prevention and Reactivation Care Programme (PReCaP), an innovative program aimed at reducing hospital related functional decline among elderly patients by offering interventions that are multidisciplinary, integrated and goal-oriented at the physical, social, and psychological domains of functional decline.


CONCLUSIONS
This paper presents a detailed description of the intervention, which incorporates five distinctive elements: (1) Early identification of elderly patients with a high risk of functional decline, and if necessary followed by the start of the reactivation treatment within 48 h after hospital admission; (2) Intensive follow-up treatment for a selected patient group at the prevention and Reactivation Centre; (3) Availability of multidisciplinary geriatric expertise; (4) Provision of support and consultation of relevant professionals to informal caregivers; (5) Intensive follow-up throughout the entire chain of care by a casemanager with geriatric expertise. Outcome and process evaluations are ongoing and results will be published in a series of forthcoming papers. This article is an edited translation of the previously published article 'Integrated approach to prevent functional decline in hospitalized elderly: the Prevention and Reactivation Care Program (PReCaP), BMC Geriatrics 2012;12:7, AJBM de Vos, KJE Asmus-Szepesi, TJEM Bakker, PL de Vreede, JDH van Wijngaarden, EW Steyerberg, JP Mackenbach, AP Nieboer.
Instituut Beleid & Management Gezondheidszorg, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands, a.devos@bmg.eur.nl.
A J B M
AJ
de Vos
K J E
KJ
Asmus-Szepesi
T J E M
TJ
Bakker
P L
PL
de Vreede
J D H
JD
van Wijngaarden
E W
EW
Steyerberg
J P
JP
Mackenbach
A P
AP
Nieboer
D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D019033:Delivery of Health Care, Integrated / Q000379:methods* / Q000639:trends; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006760:Hospitalization; D006801:Humans; D009483:Neuropsychological Tests; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000639:trends; D011315:Preventive Medicine / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology