A Pilot Study of a Multicomponent Interventions in Acute Geriatric Care: Effects on Functional Outcomes and Mobility

Area of Science:

• Gerontology
• Geriatric Medicine
• Rehabilitation

Background:

• Hospital-induced immobility negatively impacts older adults' functional status and can lead to delirium.
• Acute care settings often exacerbate functional decline in elderly patients.
• There is a need for effective interventions to maintain mobility in hospitalized older adults.

Purpose of the Study:

• To evaluate the preliminary efficacy of the Help, Optimise and Mobilise Elders (H.O.M.E) intervention.
• To assess the H.O.M.E intervention's impact on functional mobility and independence in older inpatients.
• To explore secondary outcomes including delirium incidence and length of hospital stay.

Main Methods:

• A quasi-experimental design was employed to study the H.O.M.E intervention.
• The intervention group (n=42) received tailored pre-mobilisation assessments, regular mobilisation, and weekly group physiotherapy and art activities.
• The control group (n=39) received standard hospital care. Functional mobility (maximum walking distance, gait speed, Modified Barthel Index) was assessed at baseline and discharge.

Main Results:

• The H.O.M.E intervention group demonstrated significantly greater improvement in Modified Barthel Index scores compared to the control group (p=0.02).
• No significant differences were observed between groups in gait speed, maximum walking distance, hospital length of stay, or costs.
• The intervention group showed a trend towards reduced self-reported functional decline at 30 days post-discharge (OR=0.35, p=0.047).

Conclusions:

• The H.O.M.E intervention effectively enhanced functional independence during hospitalisation for older adults.
• The intervention shows potential for reducing medium-term functional decline post-discharge.
• The findings underscore the necessity of continued care and support beyond the hospital stay to sustain benefits.