title: Slow Stream Rehabilitation: A New Model of Post-Acute Care.
abstract: OBJECTIVE
  To identify characteristics and outcomes of elderly patients admitted to a slow stream, low-intensity, and long-duration inpatient rehabilitation (SSR) program after an acute hospitalization because they were unable to tolerate traditional inpatient rehabilitation.
  
  
  METHODS
  Single group pre-post study with assessments conducted on admission and discharge.
  
  
  METHODS
  Baycrest's 30-bed SSR Unit in Toronto, Ontario, Canada.
  
  
  METHODS
  A total of 104 patients older than 60 years admitted between September 2011 and December 2012.
  
  
  METHODS
  Admission assessments included demographic data, Functional Independence Measure (FIM), and ability to ambulate. Discharge outcomes included change in motor and total FIM scores from admission to discharge, discharge residential status, and length of stay.
  
  
  RESULTS
  Mean age was 81.6 ± 8.4 years and 68.3% were women. Mean changes in motor and total FIM were 21.0 ± 12.2 (P < .001) and 22.6 ± 14.0 (P < .001), respectively. On admission, only 30.8% of patients were ambulatory even with mobility assistive devices, while on discharge, 68.3% of patients were ambulatory; 61.5% of patients returned to their preadmission living arrangement; 8.6% went from their own home to a retirement or relative's home. Only 16.3% were discharged to long-term nursing home care and 13.4% were transferred to an acute hospital. Mean length of SSR stay was 82.5 ± 26.4 days.
  
  
  CONCLUSIONS
  SSR programs can benefit elderly patients at risk for institutionalization after acute hospitalization by improving their functioning and mobility, and allowing them to return to the community.
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Grace
authors.initials: G
authors.lastname: Leung
authors.affiliation: Department of Geriatrics, Florida State University College of Medicine, Tallahassee, FL.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Katz
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Baycrest Health Sciences, Toronto, ON, Canada; Department of Psychology, Buffalo State University, Buffalo, NY.
authors.forename: Jurgis
authors.initials: J
authors.lastname: Karuza
authors.affiliation: School of Nursing, Purdue University, West Lafayette, IN.
authors.forename: Greg W
authors.initials: GW
authors.lastname: Arling
authors.affiliation: Department of Medicine, Baycrest Health Sciences, Toronto, ON, Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Chan
authors.affiliation: Department of Medicine, Baycrest Health Sciences, Toronto, ON, Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: Berall
authors.affiliation: Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.
authors.forename: Shafagh
authors.initials: S
authors.lastname: Fallah
authors.affiliation: Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Division of Biostatistics, Dalla Lana School of Public Health, Toronto, ON, Canada.
authors.forename: Malcolm A
authors.initials: MA
authors.lastname: Binns
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Baycrest Health Sciences, Toronto, ON, Canada; Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. Electronic address: gnaglie@baycrest.org.
authors.forename: Gary
authors.initials: G
authors.lastname: Naglie
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D017146:Models, Organizational; D009864:Ontario; D020127:Recovery of Function; D012046:Rehabilitation / Q000379:methods* / Q000458:organization & administration*; D012047:Rehabilitation Centers
keywords: Geriatrics; functional outcome; rehabilitation