Long-term community outcome following medical rehabilitation in older adults

• Main Author: Walsh, Priscilla Ferris
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-1999
• Subjects: Clinical psychology; Gerontology; Physical therapy; Psychotherapy; Rehabilitation; Therapy
• ISBN: 9780599582132; 0599582138

This prospective study examined factors contributing to the long term maintenance of independent living in older patients (M = 74.4 years) who lived entirely alone prior to a medical rehabilitation admission. One hundred forty subjects were recruited during inpatient rehabilitation and administered measures of cognition, depression, social support, medical burden, and self-care skills. They were followed at discharge and at three and six months post-discharge to identify factors predicting independent living (living alone). Logistic regression analyzes indicated that better basic self-care skills at discharge (Functional Independence Measure; FIM) predicted living alone at discharge and at three and six months post-discharge, as did medical burden (index of Co-Morbidity; CMI) at three months post-discharge. Intact cognition (Dementia Rating Scale; DRS) was a significant predictor of discharge home alone over and above functional status. Patients living alone had significantly higher DRS scores than those living with supervision at three and six months post-discharge. Blocks of demographics, depression, and social support measures were not significant predictors of living status. These results confirmed the importance of intact cognition to return to and maintenance of independent living and thus the importance of a thorough evaluation of cognitive status along with physical abilities in this population of older adults.