Functional Profile of Older Adults Hospitalized in Convalescence Units of the National Network of Integrated Continuous Care of Portugal: A Longitudinal Study

Abstract

Aim: To evaluate the evolution of the functional profile of older adults admitted to a health unit in Portugal; to relate the functional profile of these individuals with age, sex, education level and emotional state; and to evaluate the probability of the degree of dependence as a function of age and sex. Methods: longitudinal, retrospective study with a sample of 59,013 older adults admitted to convalescence units of the National Network of Integrated Continuous Care of Portugal. Results: In the first 75 days of hospitalization, activities of daily living, mobility and cognitive state improved, but there was a decline after 75 days of hospitalization. The ability to perform instrumental activities of daily living improved in the first 15 days of hospitalization, stabilized until 45 days and then began to worsen. Women had a higher probability of having a severe/complete dependence three years earlier than men (88 years to 91 years). A higher education level and stable emotional state were protective factors against functional decline. Conclusions: The functional profile of older adults improved during the length of stay recommended for hospitalization in convalescence units (30 days). It is critical for health systems to adopt strategies to prevent declines in the emotional state of frail individuals.

Long-term care units: a Portuguese study about the functional profile

“…In terms of age, individuals who are over 85 years old are in the severe/complete dependence group, the group between 65 and 84 years old are in the moderate dependence group and most individuals between 65 and 74 years of age are in the mild dependence group, which is in line with studies that show that older people have poor functionality (Yeh et al, 2014;Micheli et al, 2018). The same fact was verified when analyzing global data from the National Network of Integrated Continuous Care (Convalescence Units) in Portugal (Ramos et al, 2021).…”

“…These data are in line with studies that demonstrate that during hospitalization, older people with compromised mobility tend to worsen at the beginning of their stay in terms of carrying out their activities of daily living, but during the period of hospitalization in long-term care units, these patients tend to show an improvement with physical rehabilitation ( Crocker et al, 2013 ; Cuevas-Lara et al, 2021 ). However, an analysis of the study carried out in convalescence units shows an improvement in all domains in the first 30 days ( Ramos et al, 2021 ). Therefore, we can infer the importance of correctly assessing people’s needs and rehabilitation potential prior to referral to an integrated continued care unit.…”

Personalized Nursing and Health Care: Advancing Positive Patient Outcomes in Complex and Multilevel Care Environments

“…There is also a need to increase the multidisciplinarity of care assessment, planning, delivery and evaluation, where different professions and disciplines work with the person at the centre of care and treatment; there has never been a better time to do this than now due to developments in precision medicine, personalized treatment and care, digitalisation [18] and consumer/community participation. All these contemporary trends and support systems can facilitate increased agency on behalf of patients/persons in need of care and can facilitate the health literacy and agency needed to individualise care directed by the person with health needs [19]. However, some further developments are to improve the 'individual/person literacy' on behalf of health care professionals and how this information is collected, shared and implemented in care decisions [20].…”