A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people

Fleming, Sarah A., Blake, Holly, Gladman, John R.F., Hart, Elizabeth, Lymbery, Mark, Dewey, Michael E., McCloughry, Helen, Walker, Marion F. and Miller, Paul (2004) A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people. Age and Ageing, 33 (4). pp. 384-390. ISSN 1468-2834

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Abstract

Objectives: to evaluate the effect of a care home rehabilitation service on institutionalisation, health outcomes and service use.

Design: randomised controlled trial, stratified by Barthel ADL index, social service sector and whether living alone. The intervention was a rehabilitation service based in Social Services old people's homes in Nottingham, UK. The control group received usual health and social care.

Participants: 165 elderly and disabled hospitalised patients who wished to go home but were at high risk of institutionalisation (81 intervention, 84 control).

Main outcome measures: institutionalisation rates, Barthel ADL index, Nottingham Extended ADL score, General Health Questionnaire (12 item version) at 3 and 12 months, Health and Social Service resource use.

Results: the number of participants institutionalised was similar at 3 months (relative risk 1.04, 95% confidence intervals 0.65–1.65) and 12 months (relative risk 1.23, 95% confidence intervals 0.75–2.02). Barthel ADL Index, Nottingham Extended ADL score and General Health Questionnaire scores were similar at 3 and 12 months. The intervention group spent significantly fewer days in hospital over 3 and 12 months (mean reduction 12.1 and 27.6 days respectively, P < 0.01), but spent a mean of 36 days in a care home rehabilitation service facility.

Conclusions: this service did not reduce institutionalisation, but diverted patients from the hospital to social services sector without major effects on activity levels or well-being.

Item Type: Article
RIS ID: https://nottingham-repository.worktribe.com/output/703192
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Ageing following peer review. The version of record A randomised controlled trial of a care home rehabilitation service to reduce long-term institutionalisation for elderly people / Sarah A. Fleming , Holly Blake, John R.F. Gladman, Elizabeth Hart, Mark Lymbery, Michael E. Dewey, Helen McCloughry, Marion Walker and Paul Miller is available online at: http://ageing.oxfordjournals.org/content/33/4/384
Keywords: health services for the aged, rehabilitation, care homes, randomised controlled trial, elderly
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rehabilitation and Ageing
Identification Number: https://doi.org/10.1093/ageing/afh126
Depositing User: Eprints, Support
Date Deposited: 13 Dec 2016 10:37
Last Modified: 04 May 2020 16:25
URI: https://eprints.nottingham.ac.uk/id/eprint/39345

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