Care complexity in hospitalized elderly according to cognitive performance

Abstract

Objective: to investigate possible differences in care complexity, functional performance and biopsychosocial and health system aspects among hospitalized elderly with or without cognitive decline. Method: quantitative, cross-sectional and analytical study in which was used the INTERMED method and cognitive and functional screening scales. We investigated 384 elderly patients admitted to a medical and surgical clinic of a University Hospital located in São Paulo/SP. Results: cognitive decline was present in 40.1% of the sample, most of them were longer-lived elderly individuals with less schooling and income, more dependent in activities of daily living and had greater vulnerability in different domains of INTERMED. After adjustments, the elderly with cognitive decline presented greater vulnerability in the psychological domain. Conclusion: the relationship between cognitive decline and psychological vulnerability highlights the need to adopt long-term care based on involvement of the family, health team and different services, thereby maximizing the quality of care.

Evaluation of Complexity Measurement Tools for Correlations with Health-Related Outcomes, Health Care Costs and Impacts on Healthcare Providers: A Scoping Review

“…While 9 out of 21 tools were used in primary care settings, the others were used only for inpatients. We identified 25 studies that investigated the correlation between patients’ complexity and health-related outcomes [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 42 , 43 ]. Two studies investigated the correlation between patients’ complexity with healthcare related costs [ 25 , 28 ].…”

Nursing diagnoses of impaired memory and chronic confusion for older adults: diagnostic content validation

“…The processes of retaining and recalling information or skills are critical parts of the memory, that might be related to several chronic diseases other than dementia (9,(28)(29) and directly interfere with the ability of elders to learn and keep new information and competencies (3) . This inability may pose the necesssity to start taking notes and increasing focus in attention to maintain activities independently (30) .Thus, the impairment of these abilities constitutes critical attributes for IM and further justifies the relevance of these DC.…”

“…The use of instruments that allow identification of human responses related to the neurcognitive abilities may support nurses to implement a more effective nursing care plan for older adults with neurocognitive disorders. With the progression of cognitive decline in older adults, the complexity of care progresses proportionally, increasing dependence and vulnerability Therefore, these aspects need to be considered by those involved: family, caregivers, health care professionals and gerontological nurses to provide integral care (29) .…”