Purpose To describe a guidance on the management of post-acute COVID 19 patients in geriatric rehabilitation. Methods The guidance is based on guidelines for post-acute COVID-19 geriatric... Show morePurpose To describe a guidance on the management of post-acute COVID 19 patients in geriatric rehabilitation. Methods The guidance is based on guidelines for post-acute COVID-19 geriatric rehabilitation developed in the Netherlands, updated with recent insights from literature, related guidance from other countries and disciplines, and combined with experiences from experts in countries participating in the Geriatric Rehabilitation Special Interest Group of the European Geriatric Medicine Society. Results This guidance for post-acute COVID-19 rehabilitation is divided into a section addressing general recommendations for geriatric rehabilitation and a section addressing specific processes and procedures. The Sect. "General recommendations for geriatric rehabilitation" addresses: (1) general requirements for post-acute COVID-19 rehabilitation and (2) critical aspects for quality assurance during COVID-19 pandemic. The Sect. "Specific processes and procedures", addresses the following topics: (1) patient selection; (2) admission; (3) treatment; (4) discharge; and (5) follow-up and monitoring. Conclusion Providing tailored geriatric rehabilitation treatment to post-acute COVID-19 patients is a challenge for which the guidance is designed to provide support. There is a strong need for additional evidence on COVID-19 geriatric rehabilitation including developing an understanding of risk profiles of older patients living with frailty to develop individualised treatment regimes. The present guidance will be regularly updated based on additional evidence from practice and research.Key summary pointsAim To describe a guidance on the management of post-acute COVID 19 patients in geriatric rehabilitation. Findings This guidance addresses general requirements for post-acute COVID-19 geriatric rehabilitation and critical aspects for quality assurance during the COVID-19 pandemic. Furthermore, the guidance describes relevant care processes and procedures divided in five topics: patient selection; admission; treatment; discharge; and follow-up and monitoring. Message This guidance is designed to provide support to care professionals involved in the geriatric rehabilitation treatment of post-acute COVID-19 patients. Show less
Due to the rising life expectancy and improved treatment possibilities of chronic illness and acute care, the group of older persons will continue to increase worldwide. Concurrently, the number of... Show moreDue to the rising life expectancy and improved treatment possibilities of chronic illness and acute care, the group of older persons will continue to increase worldwide. Concurrently, the number of older people with multi-morbidities in acute care will also increase. Geriatric rehabilitation is important for this specific population, because it has a positive effect on the improvement of functioning after hospitalization, and leads to less re-admissions to nursing homes/hospitals and to lower mortality rates.Geriatric rehabilitation is a multidisciplinary set of evaluative, diagnostic and therapeutic interventions with the purpose to restore functioning or enhance residual functional capacity in older people with disabling impairments. Geriatric rehabilitation treatment has a multidisciplinary patient-centered approach.Internationally, post-acute care rehabilitation is provided in different settings. In the Netherlands, geriatric rehabilitation is provided in the post-acute care setting of skilled nursing facilities (SNFs). However, because geriatric rehabilitation is a relatively young field of research we are still in the early stages of exploring which aspects of structure and processes may help to improve successful geriatric rehabilitation outcomes.The general aim of this thesis is to investigate various aspects of the structure and processes in geriatric rehabilitation in relation to the outcome of successful rehabilitation. Show less
OBJECTIVE Although geriatric rehabilitation (GR) is beneficial for restoration of activities and participation after hospitalization of vulnerable older persons, little is known about the optimal... Show moreOBJECTIVE Although geriatric rehabilitation (GR) is beneficial for restoration of activities and participation after hospitalization of vulnerable older persons, little is known about the optimal organization of care of these postacute facilities. This study examines the relationship of patient volume and service concentration with successful GR (short length of stay and discharge home) in skilled nursing facilities (SNFs). DESIGN A national multicenter retrospective cohort study. SETTING AND PARTICIPANTS All patients indicated for GR in a Dutch SNF. MEASUREMENTS Nurses filled out digital registration forms from patient records. Patients were studied in 3 predefined diagnostic groups: total joint replacement, traumatic injuries, and stroke. Facility characteristics were obtained by structured telephone interviews with facility managers. Volume was based on the number of discharges in a 3-month period and categorized in low-, medium-, and high-volume facilities. Concentration was defined at the organizational level in which the population consists of 80% or more of 1 or 2 diagnostic groups, with the prerequisite of having a minimum of 10 rehabilitation beds. RESULTS From 88 facilities, 2269 GR patients (mean age 78.2 years [SD 9.7]; 68.2% female) were included. The median length of stay in the SNF was 45 days (interquartile range 23-81), 57% of the patients were discharged home, and 9.8% died during GR. Of patients with total joint replacement (n = 501), concentration was related to successful rehabilitation (odds ratio 5.7; 95% confidence interval 1.3-24.3; P = .020, adjusted for age and gender); this relationship was not found for patients with traumatic injuries or stroke. Volume showed no relation with successful rehabilitation in any of the 3 diagnostic groups. CONCLUSION This study may indicate that concentration in an SNF, as a proxy for specialization, favors successful GR in total joint replacement. This relationship was not found for the traumatic injuries or stroke groups, or for volume. The relation on functional outcome in GR needs further investigation. Show less
