ASSESSING AND RESTORING FUNCTION IN ELDERLY PEOPLE - MORE THAN REHABILITATION

Objective: To quantify the medical component of assessing and restorin g function in the elderly and to determine if a subset who did not req uire medical input could be identified. Design: Prospective consecutiv e sample. Setting: Inpatient assessment, treatment and rehabilitation unit for the elderly in New Zealand. Patients: Two hundred patients ag ed 60-98 years. Main outcome measures: (1) Proportion of elderly peopl e receiving rehabilitation who also required treatment of medical prob lems. (2) Characteristics of those not requiring medical input. Result s: One hundred and seventy-two (86%) of people required some medical i nput during their hospital stay for rehabilitation. Forty-nine per cen t had medical conditions which had a direct impact on their rehabilita tion. Rehabilitation was delayed for a mean 16.8 (13.0-20.6)% of hospi tal stay when significant medical problems required treatment. People with previously undiagnosed conditions affecting rehabilitation tended to be older. The referral diagnoses most likely to result in an uncom plicated inpatient stay (i.e. rehabilitation only or rehabilitation wi th treatment of minor medical problems) were postsurgical treatment (5 5% uncomplicated), stroke (47% uncomplicated) or amputation (55% uncom plicated). However, 45-53% of people with these problems had a major m edical component to their stay. People with other referral diagnoses o r those admitted from institutions for the elderly were more likely to have a medical component to their stay. Conclusion: Restoration of fu nction in the elderly requires a combination of both medical and rehab ilitation skills. Reliable predictors of those not requiring medical i nput could not be found.