Mobility and Self-Care are Associated With Discharge to Community After Home Health for People With Dementia.
Sara Knox, Brian Downer, Allen Haas and 1 others
PMID 33476569WHAT IT FOUND
In home health, people with dementia had lower successful discharge to community: 71% versus 81% without dementia.
Greater dependence in mobility or self-care was the strongest observed risk factor.
Key findings
01In the final home health cohort, 79.4% had successful discharge to community.
02People with dementia had 71% successful discharge, compared with 81% for people without dementia.
03Successful discharge fell to 72% in the most dependent quartiles of mobility and self-care.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
Dementia was identified only from ICD-10 codes, which can miss cases and cannot distinguish dementia stages. Medication management covered only oral medications, not injections or IV medications. Mobility, self-care, caregiver support, and medication status were measured only at home health admission, so changes during the episode were not considered. The study is observational, so it shows association with discharge but not that any treatment caused better discharge. OASIS item validity varies, with functional items strongest and cognition more moderate.
Declared interests
No conflicts of interest were declared. The paper is listed as supported by an NIH extramural research grant.
The easy way to misread this
Do not conclude that dementia, poor mobility, or weak caregiver support caused unsuccessful discharge. This observational study measured these factors at home health admission and cannot show that changing them will improve discharge.