Many seniors who visit emergency departments overestimate their ability to handle physical tasks, a mistake that can lead to hospital readmission later, according to study findings recently published in Annals of Emergency Medicine.
“Ensuring that older adults discharged from the emergency department are able to safely function in their home environment is important because those who are unable to function safely at home are at risk for falls and return ER visits,” Timothy Platts-Mills, MD, MSc, of the University of North Carolina Chapel Hill in Chapel Hill, N.C., and lead author of the study, said in a press release. “Accurately determining the ability of these patients to care for themselves at home is critical for emergency physicians as they make decisions about whether to discharge patients [to their] home or elsewhere. A patient who reports they can walk with an assistive device but actually requires human assistance to walk is likely to be bed-bound or to fall if they go home alone.”
Seniors who participated in the study were assigned to tasks including getting out of bed, walking 10 feet and returning to bed. Platts-Mills and colleagues found that just 77% of patients studied were able to accurately assess their ability to perform tasks. Twelve percent of those who said they could perform the assigned tasks without assistance did require some assistance or were unwilling to complete the tasks. Of those who said they could perform the task with a cane or walker, 48% required either human assistance or were unable to perform the task, whereas 24% of those who said they could perform the tasks with human assistance were unable to do so.
“Emergency physicians are experts in deciding who can go home and who needs to come in the hospital,” Platts-Mills said. “But we are not perfect and sometimes we make decisions based on patient statements about abilities, rather than direct assessments. Our results suggest that patient statements are sometimes inaccurate, and, particularly for older adults who need some assistance, directly observing the patient’s ambulation can be informative. Of course, being able to move around isn’t the only determinant of whether an older adult can be safely sent home, but it is a critical piece of information and it’s good to get it right.”
Reference: Platts-Mills T, et al. Ann Emerg Med. 2015;doi: 10.1016/j.annemergmed.2015.07.007
