Related Experiment Video
Updated: Jul 4, 2026
06:52
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Do relatives of elderly patients block the discharge process?
P Gallagher1, C Henry, N O'Callaghan
1South Infirmary Victoria University Hospital, Old Blackrock Road, Cork. pfgallagher77@eircom.net
Irish Medical Journal
|June 11, 2008
Summary
Family members rarely delay hospital discharge for older patients. Delays primarily stem from issues accessing long-term care and community support services, not family opposition.
Area of Science:
- Geriatric Medicine
- Health Services Research
- Hospital Management
Background:
- A prevalent perception suggests that relatives of elderly patients impede hospital discharge, exacerbating capacity issues in emergency departments.
- This perception warrants investigation to understand the true drivers of delayed discharge in acute care settings.
Purpose of the Study:
- To prospectively analyze the reasons for delayed discharge in older patients from an acute general hospital.
- To quantify the impact of delayed discharge on hospital bed occupancy.
- To determine the extent to which relatives' opposition contributes to discharge delays.
Main Methods:
- Prospective analysis of 1,240 consecutive referrals to a hospital discharge coordinator over two years.
- Calculation of bed-days consumed by delayed discharges.
- Categorization of reasons for delay, including assessment of relative's stance on discharge.
Main Results:
- Ninety cases of delayed discharge were identified, accounting for 2,436 consumed bed-days.
- Primary reasons for delay were difficulties accessing long-term care facilities and organizing community support services.
- Relatives opposed discharge in only 9 of the 90 delayed cases, often due to concerns about inadequate community support.
Conclusions:
- The perception of relatives frequently blocking discharge is largely unfounded.
- Delayed discharge is predominantly an systemic issue related to healthcare infrastructure and community care provision.
- Relatives act as patient advocates, highlighting deficiencies in available support systems for older adults and their caregivers.
Related Concept Videos
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
01:28Esophageal Varices-II: Clinical Features and Management
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
01:21Barriers to Effective Communication II
The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:31Discharge Summary Forms
The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...