Duration of stay and outcome for inpatients on an assessment ward for elderly patients with cognitive impairment

Abstract

The move away from the provision of long‐stay beds by the NHS inevitably meant a change in function for wards for elderly patients with cognitive impairment to a more acute way of working. Literature is scarce on the role or effectiveness of the new assessment wards that have replaced them and the factors affecting outcome and the duration of stay. Evidence suggests that those patients with higher dependency levels and behavioural problems stay in hospital longer, as do those awaiting a nursing home placement.This paper reports a prospective study of a consecutive group of 101 patients who died on or were discharged from an acute assessment ward for elderly patients with cognitive impairment. Clinical characteristics were recorded according to an in‐patient dementia care pathway, which included Mini‐MOUSEPAD, Crichton activities of daily living, Mini‐Mental State Examination and the Burvill physical health score evaluations. Outcome measures were duration of stay, destination on discharge or death on the ward.Most patients had cerebrovascular disease (48%) or Alzheimer's disease (32.9%), and their average Mini‐Mental State Examination score was 14.9. The mean duration of stay was 7.9 weeks. Self‐funding status and lack of behavioural and psychological complications were associated with a reduced duration of stay. 22.2% of patients were successfully rehabilitated to their own homes, but 20% died. Discharge home was most strongly predicted by having a spouse at home, and the need for nursing home rather than residential care was related to the severity of cognitive impairment. This study concludes that patients can expect to stay in hospital for 8 weeks but two areas of concern are highlighted. Firstly, the importance of the funding of community rehabilitation for patients with memory disorders and, secondly, the importance of a spouse at home to look after the patient.

Citation

Ball, S., Simpson, S., Beavis, D. and Dyer, J. (2004), "Duration of stay and outcome for inpatients on an assessment ward for elderly patients with cognitive impairment", Quality in Ageing and Older Adults, Vol. 5 No. 2, pp. 12-20. https://doi.org/10.1108/14717794200400009