Eric Bressman, M.D., from University of Pennsylvania in Philadelphia, and colleagues estimated trends in the frequency and duration of receipt of help with activities of daily living (ADLs) among older adults discharged home. The analysis included 3,591 respondents to the National Health and Aging Trends Study who were 69 years or older and were discharged from an acute care hospital to home between 2011 and 2017.
The researchers found that 44.1 percent of participants reported receiving help within three months of discharge, with the need for help declining to prehospitalization levels over nine months. Those receiving help were older (mean, 79.7 versus 77.6 years), had worse self-rated health at baseline (47.1 percent with fair or poor health versus 26.5 percent), and were more likely to have dementia (21.8 versus 5.5 percent) compared with people not receiving help. Overall, the percentage of respondents who reported receiving help increased from 38.1 percent of hospital discharges in 2011 to 51.5 percent in 2017. There was an even greater increase seen when limiting the analysis to participants who were independent in their ADLs before hospitalization (from 9.3 percent receiving help in 2011 to 31.8 percent in 2017).
“As the use of institutional postacute care declines over time, additional attention will need to focus on whether the shift home increases the burden of care on family and friends and whether additional support is needed to support home-based care,” the authors write.