Factors Associated with a Label of Failure to Cope in Older Medical Inpatients: a Case-Control Study

The term failure to cope (FTC) is often used to dismissively describe hospitalized older adults. The purpose of this study was to identify the factors associated with receiving a label of FTC.

Age-matched, case-control study with electronic and paper chart review identifying patient characteristics and admission details.

One hundred eighty-five patients 70 years of age or older admitted to a general medicine team over two years: 99 patients with the label of FTC and 86 controls. No patients labelled with FTC came from long-term care. Characteristics associated with a label of FTC included living alone (aOR 3.8, 95% CI 1.9-7.8), falls (aOR 3.8, 95% CI 1.9-7.8), rehospitalization (aOR 3.6, 95% CI 1.7-8.0), and living in an independent dwelling (aOR 2.4, 95% CI 1.0-5.5). A higher number of chronic medications was associated with a lower likelihood of being labelled with FTC (aOR 0.9, 95% CI 0.8-1.0).

The results suggest that FTC is a label based predominantly on social factors and has no role in a medical assessment. The patient's home setting was the key factor in being labelled with FTC, most medical factors did not play a significant role, and a pervasive language of blame was present.