Transitional care: filling the gap for older patients

Area of Science:

• Geriatrics
• Health Services Research
• Continuum of Care

Background:

• Frail older adults often remain hospitalized post-acute illness due to functional deficits.
• Acute care settings may lack resources for comprehensive geriatric care.
• A gap exists in post-acute care for frail elders needing functional recovery.

Purpose of the Study:

• To evaluate a transitional care program for frail elders.
• To assess the program's impact on functional levels.
• To determine the effect on hospital bed utilization.

Main Methods:

• Implementation of a transitional care program at Mississauga Hospital.
• Focus on improving functional status in frail elderly patients.
• Monitoring of patient discharge readiness and bed occupancy.

Main Results:

• The transitional care program enhanced the functional capacity of frail elders.
• Improved functional levels facilitated earlier discharge from hospital.
• The program contributed to more efficient hospital bed utilization.

Conclusions:

• Transitional care is effective in managing frail elders post-acute illness.
• This model of care bridges the gap between acute and home care.
• Implementing such programs optimizes healthcare resource allocation.