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A Geriatric Day Hospital: Who Improves the Most?

Published online by Cambridge University Press:  31 March 2010

Johanne Desrosiers ,
Réjean Hébert ,
Hélène Payette ,
Pierre-Michel Roy ,
Michel Tousignant ,
Sylvie Côté  and
Lise Trottier
Johanne Desrosiers*
Affiliation:
Research Centre on Aging, Sherbrooke Geriatric University Institute Faculty of Medicine, Université de Sherbrooke
Réjean Hébert
Affiliation:
Research Centre on Aging, Sherbrooke Geriatric University Institute Faculty of Medicine, Université de Sherbrooke
Hélène Payette
Affiliation:
Research Centre on Aging, Sherbrooke Geriatric University Institute Faculty of Medicine, Université de Sherbrooke
Pierre-Michel Roy
Affiliation:
Faculty of Medicine, Université de Sherbrooke Sherbrooke Geriatric University Institute
Michel Tousignant
Affiliation:
Research Centre on Aging, Sherbrooke Geriatric University Institute Faculty of Medicine, Université de Sherbrooke
Sylvie Côté
Affiliation:
Research Centre on Aging, Sherbrooke Geriatric University Institute Sherbrooke Geriatric University Institute
Lise Trottier
Affiliation:
Research Centre on Aging, Sherbrooke Geriatric University Institute
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Dr. Johanne Desrosiers, Research Centre on Aging, 1036 Belvédère sud, Sherbrooke (Québec), J1H 4C4. (johanne.desrosiers@USherbrooke.ca)
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Abstract

This study compared the changes in some bio-psychosocial variables (functional independence, nutritional risk, pain, balance and walking, grip strength, general well-being, psychiatric profile, perception of social support, leisure satisfaction, and caregivers' feeling of burden) in four categories of clients during their program at a geriatric day hospital (GDH). The study also evaluated whether or not improvements, if any, were maintained 3 months after discharge. One-hundred-and-fifty-one people, categorized by primary reason for admission, were assessed at the GDH with reliable and valid tools, at admission and at discharge. Three months after discharge, they were reassessed with the same tools. Overall, two categories of clients, stroke / neurological diseases and musculoskeletal disorders / amputations, improved the most. For the gait disorders and falls group, only the functional independence score improved, but not at a clinically significant level. Finally, clients in the cognitive function disorders / psychopathologies group improved the most on their well-being scores and caregivers' burden decreased the most. All gains were maintained up to 3 months after discharge, except for leisure satisfaction. With the exception of clients who attended the GDH because of gait disorders and falls, the improvements and maintenance achieved in each category occurred in the domains where improvement had been hoped for, because of the particular disabilities in question and because of the nature of the GDH services offered.

Résumé

Cette étude visait à comparer les changements de variables bio-psychosociales (indépendance fonctionnelle, risque nutritionnel, douleur, équilibre et marche, force de préhension, bien-être général, profil psychiatrique, perception du support social, satisfaction dans les loisirs et sentiment de fardeau des proches-aidants) de quatre catégories de clients durant leur séjour dans un hôpital de jour gériatrique (HJG). L'étude a aussi évalué si les changements obtenus durant le séjour étaient maintenus et ce, sur une période de 3 mois après le congé. Cent cinquante et une personnes, regroupées par catégorie de motifs principaux d'admission, ont été évaluées à l'admission et au congé de l'HJG avec des instruments de mesure fidèles et valides. Trois mois suivant le congé, ils ont été évalués de nouveau (n = 126) avec les mêmes instruments. De façon générale, deux catégories de personnes, « AVC / Maladies neurologiques» et «Troubles musculosquelettiques / Amputations» se sont le plus améliorées. Chez les personnes présentant des «Troubles de la démarche et chutes», seul le score total de l'échelle de l'autonomie fonctionnelle s'est statistiquement amélioré. Finalement, les personnes regroupées sous la catégorie «Troubles des fonctions cognitives / Psychopathologies» sont celles qui ont amélioré le plus leurs scores de bien-être général; de plus, on a observé une diminution du sentiment de fardeau chez leurs proches-aidants. Tous les gains observés se sont maintenus jusqu'à 3 mois suivant le congé, à l'exception de la satisfaction face aux loisirs qui a diminué. En excluant les clients qui ont fréquenté l'HJG pour des troubles de démarche et de chutes, les améliorations et les maintiens obtenus dans chaque catégorie de motifs d'admission ont été observés dans les domaines pour lesquels une amélioration était espérée, en raison des incapacités particulières et des services offerts dans le programme.

Keywords

aginggeriatric day hospitalrehabilitationfunctional independencewell-beingvieillissementhôpital gériatrique de jourréadaptationautonomie fonctionnellebien-être
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 23 , Issue 3 , Fall/Automne 2004 , pp. 217 - 228
Copyright
Copyright © Canadian Association on Gerontology 2004

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