Characteristics of Patients Described as Sub-acute in an Acute Care Hospital

Abstract

Frail older patients suffer from multiple, complex needs that often go unmet in an acute care setting. Failure to recognize the geriatric giants in frail older adults is resulting in the misclassification of this population. This study investigated "sub-acute" frail, older-adult in-patients in a tertiary care teaching hospital. Although identified as being no longer acutely ill, all participants (n = 62) required active medical and/or nursing care. Frail older patients, often acutely ill, were being misclassified as sub-acute when the acuity of their illness went unrecognized which resulted in equally unrecognized disease presentations. The majority of participants wished to be cared for at or closer to home. The lack of post-acute-care service within our health care system and risk aversion on the part of hospital staff resulted in lengthy hospital stays and/or in patients being funneled into existing services (nursing homes) against their desire to go home.

Cognitive Impairment and Length of Stay in Acute Care Hospitals: A Scoping Review of the Literature

“…Canadian Journal on Aging / La Revue canadienne du vieillissement (rehabilitation) facility. Canadian experiences with patients labelled as "subacute" suggest an uncomfortable similarity here (Elbourne, Hominick, Mallery, & Rockwood, 2013). This approach also lets hospitals off the hook for their role in nosocomial dependency, especially reduced mobility.…”

Characteristics of Older Adults Admitted to Hospital versus Those Discharged Home, in Emergency Department Patients Referred to Internal Medicine

“…( 12 ) The risk, and therefore the need for assessment, can extend even to many common types of hospital admissions, from routine to high-risk care. ( 9 , 11 , 12 , 13 , 14 , 15 , 16 )…”

On Seeing and Being Seen in Dementia Care

“…In another Canadian study, the author of the present paper and colleagues found that staff members' low level of risk tolerance towards older adults resulted in older adults not returning home from the hospital as they wished but instead being funneled into nursing homes for their own safety. 12 People with dementia must cope in addition with a negative label or social stigma associated with a dementia diagnosis. The general public and many health care professionals have little knowledge of dementia prevention and treatment until a family member develops its signs and symptoms.…”