title: Restorative care for palliative patients: a retrospective clinical audit of outcomes for patients admitted to an inpatient palliative care unit.
abstract: BACKGROUND
  Restorative care in palliative care is a subset of rehabilitation that aims to improve quality of life through restoration or maintenance of physical functions. Outcomes for restorative care programmes delivered by palliative care units have not adequately been assessed.
  
  
  OBJECTIVE
  The objectives are to examine the outcomes of a restorative care programme in an inpatient palliative care unit, including discharge destination, performance status changes and length of stay.
  
  
  METHODS
  Retrospective clinical audit of consecutive patients admitted to Calvary Health Care Bethlehem in Melbourne, Australia, principally for restorative care from July 2010 to December 2011.
  
  
  RESULTS
  79 admissions met inclusion criteria. Mean age was 76.5 years (SD=11.14) and 43 (54%) were men. 75 (95%) patients had a malignant diagnosis; of these, the majority had lung cancer (24%). 16 patients (20%) were discharged home, 51 (65%) died and 12 (15%) were transferred. Of the patients discharged home, only 6 (38% of those discharged home) improved their performance status. Those discharged home had a significantly shorter length of stay (17 days compared to 39 days; p<0.05). Patients discharged home also had significantly better Australia-modified Karnofsky Performance Status (AKPS) and Resource Utilisation Groups-Activities of Daily Living (RUG-ADL) scores on admission than others (both p<0.05).
  
  
  CONCLUSIONS
  The majority of patients referred for restorative care died during admission, with only a minority discharged home. Patients discharged most commonly experienced maintenance and not improvement in performance status. A successful discharge home following restorative care was associated with a shorter length of stay. Implications and recommendations for successful restorative care will be discussed.
authors.affiliation: Calvary Health Care Bethlehem, Caulfield, Victoria, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Runacres
authors.affiliation: Calvary Health Care Bethlehem, Caulfield, Victoria, Australia.
authors.forename: Heidi
authors.initials: H
authors.lastname: Gregory
authors.affiliation: Deakin University, Burwood, Australia Cancer Council Victoria, Melbourne, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Ugalde
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D054869:Clinical Audit; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D010166:Palliative Care / Q000706:statistics & numerical data*; D011788:Quality of Life; D000066768:Rehabilitation Research; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Palliative Care; Rehabilitation; Restorative Care