Function-Focused Goal Attainment and Discharge Outcomes in Hospitalized Persons With Dementia.
Marie Boltz, Cheryl Monturo, Cindy Brockway and 3 others
PMID 34432570WHAT IT FOUND
Among hospitalized people with dementia, achieving family-negotiated functional goals was associated with returning to baseline physical function and lower delirium at discharge.
Mobility goals were most common, and 70% of patients had at least one goal attained.
Key findings
01Goal attainment was significantly associated with return to baseline function after controlling for admission function, depressive symptoms, and cognition.
02Goal attainment was significantly associated with lower delirium severity at discharge after controlling for admission function and cognition.
03Mobility goals were the most common goals (58%), and 70% of patients had at least one goal attained.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a descriptive analysis of the intervention arm only, so it cannot show whether the family-centered function-focused care process worked compared with another group. The sample was 134 dyads from three hospitals in Pennsylvania, so other hospitals and regions may differ. The study did not examine why goals were not met, or how care partner, staff, or unit characteristics affected goal attainment. Goal attainment was based on the care partner's rating and was dichotomized, which may miss how much a goal was exceeded or missed. Patients had very mild to moderate dementia and were community-residing, so results may not apply to severe dementia or nursing home residents.
The easy way to misread this
Do not read the significant associations as proof that goal setting improved function or reduced delirium. The analysis used only the intervention arm of a trial, had no comparison group, and included assessment, education, goal negotiation, daily plan review, and discharge rating together, so the effect of any single component cannot be separated.