FUNCTIONAL DETERIORATION IN A GERIATRIC UNIT—HOW OFTEN DOES THIS HAPPEN?

Background: Most patients in a geriatric unit show an improvement of their functional abilities. But unfortunately this is not always true. Additionally due to changing financial resources the treatment results may have deteriorated over the past years. Methods: In the Center for Medicine in the Elderly in Hannover, an in-patient geriatric clinic in Germany 756 patients in 2004 and 2527 in the years 2008 to 2009 were analyzed. The measure for the activities of daily living (ADL) was the Functional Independence Measure (FIM). Moreover data from 1602 patients from 2014 were included, but here the Barthel-Index (BI) was used as ADL measure. Improvement resp. deterioration was defined as more or less than 0 points on the ADL scale between admission and discharge. Results: As shown by the FIM 5.2–6.0% of the patients deteriorated, 3.0–6.2% remained unchanged and 88.9–90.9% improved. As judged by the BI 6.2% deteriorated, 12.6% remained unchanged and 81.2% improved. Conclusion: Over ten years and with two instruments to measure activities of daily living, deterioration was only seen in about 5–6 % of the patients. About 95% remained unchanged or improved in their independence. In a usual care setting the percentage of elderly patients, who show declining ADL abilities may be much higher (e.g. Sager et al., 1996).