Up and Active: preventing functional decline for older people in general medicine wards

Ms Melanie Haley1, Ms Katherine Lawler1, Ms Anatole Jasonides1, Ms Rhiannon Pendleton1, Ms Anne Pagram1, Mr Timothy Albiston1, Ms Susan Parslow1, Mr Christopher Sloan1

1Eastern Health, Mont Albert North, Australia

Abstract:

Aim:
To test the feasibility and effectiveness of a model of care in general medicine incorporating exercise groups and a focus on reducing functional decline.

Method:
This observational study compared routinely collected data of patients ≥65 years from an intervention ward with two usual-care wards during a 6-week period.  The intervention was a thrice-weekly exercise group and a physiotherapy service that prioritised prevention of functional decline. Outcomes were length of stay, discharge destination and change in mobility status (categorical variable improved/did not improve). Length of stay was analysed using independent t tests, change in mobility status using odds ratio and discharge destination data using z tests.

Results:
Data from 369 patients were collected (Intervention n=127, Usual Care n=242).  The odds of patient mobility status improving was significantly higher on the intervention ward compared with the usual care wards (OR 2.47 (1.54-3.95) p<0.001).  There was no difference between the intervention and usual care wards for length of stay in hospital (Mean 14.0 days [SD 17.9] v Mean 11.6 days [SD 15.2] p=0.173). There was no difference in proportion discharged home (60.6% v 67.4% p=0.939), to sub-acute wards (25.2% v 19.0% p=0.167) or to new residential care (1.6% v 5.0% p=0.1065). No adverse events were experienced by patients participating in exercise groups.

Significance of the findings to allied health:
This model of physiotherapy care was feasible and improved the odds of improving mobility status but did not impact length of stay or discharge destination.

Biography:

Melanie Haley is an Aged and Complex Care physiotherapist at Eastern Health.  She has completed her Masters in Gerontology at La Trobe University, including a minor thesis on frailty in the sub-acute setting.  She is a current member of the Safer Care Victoria Care of Older People governance committee and has research interests in prevention of hospital functional decline, frailty and delirium.