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Pre-admission functional decline in hospitalized persons with dementia: The influence of family caregiver factors

Authors
 Marie Boltz  ;  Kyung Hee Lee  ;  Tracy Chippendale  ;  Rebecca L Trotta 
Citation
 Archives of Gerontology and Geriatics, Vol.74 : 49-54, 2018 
Journal Title
 Archives of Gerontology and Geriatics 
ISSN
 0167-4943 
Issue Date
2018
MeSH
*Activities of Daily Living ; Aged ; 80 and over Aged ; *Caregivers ; Dementia/*psychology ; Family ; Female ; *Hospitalization ; Humans ; Male ; Patient Admission
Keywords
Dementia pre-hospitalization ; Family caregiver ; Functional decline
Abstract
Older adults with dementia are more likely than those who do not have dementia to be hospitalized. Admission functional (ADL) performance is a salient factor predicting functional performance in older adults at discharge. The days preceding hospitalization are often associated with functional loss related to the acute illness. An understanding of functional changes during this transition will inform interventions to prevent functional decline. This secondary analysis examined data from a study that evaluated a family educational empowerment model and included 136 dyads (persons with dementia and their family caregiver). AMOS structural equation modeling examined the effects of family caregiver factors upon change in patient ADL performance (Barthel Index) from baseline (two week prior to hospitalization) to the time of admission, controlling for patient characteristics. Eighty-two percent of the patients had decline prior to admission. Baseline function, depression, and dementia severity, as well as Family caregiver strain, were significantly associated with change in pre-admission ADL performance and explained 40% of the variance. There was a good fit of the model to the data (Chi(2)(=)12.9, p=0.305, CFI=0.97, TLI=0.90, RMSEA=0.05). Findings suggest the need for a function-focused approach when admitting patients with dementia to the hospital. FCG strain prior to hospitalization may be a factor impacting trajectory of functional changes in older person with dementia, especially in those with advanced dementia. FCG strain is an important assessment parameter in the risk assessment for functional decline, to be considered when engaging the FCG in the plan for functional recovery.
Full Text
https://www.sciencedirect.com/science/article/pii/S0167494317302868
DOI
10.1016/j.archger.2017.09.006
Appears in Collections:
3. College of Nursing (간호대학) > Dept. of Nursing (간호학과) > 1. Journal Papers
Yonsei Authors
Lee, Kyung Hee(이경희) ORCID logo https://orcid.org/0000-0003-2964-8356
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162010
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