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Depression associated with higher discharge-related failure rate, longer length of stay in nursing homes, study suggests
Tuesday, May 08 2007 | Comments
What's This?
Elderly patients with depression may have a longer length of stay in rehabilitation nursing homes and a higher incidence of discharge-related failure, a 40-patient study demonstrated.The current study included patients who were admitted to the Sunrise Health and Rehabilitation Center in Sunrise, Fla., during a 1-year period. Individuals with moderate or severe dementia (Mini-Mental State Examination score <15), terminal illness, hemiplegia, or an inability to walk were excluded from the analysis. All patients were screened for depression with the Geriatric Depression Scale.
Dr. Jerry Ciocon, medical director of the rehabilitation center and author of the study, evaluated the progress of patients in physical therapy, determined by the distance walked during a scheduled period of time; physical therapy attendance rates; the number of days spent at the center from admission to discharge; and the failure rate, or the percentage of patients that could not be discharged home or placed in a long-term care facility.
Of the 40 patients evaluated, 18 met criteria for depression while at the rehabilitation center.
Results demonstrated that the group with depression showed poorer progress in physical therapy, had a longer mean length of stay, had lower physical therapy attendance, and had a higher failure rate.
Specifically, during physical therapy sessions, patients with depression walked a mean of 38 feet compared with a mean of 72 feet among those without depression (P<.05). The group with depression also had worse attendance at physical therapy sessions (62% vs 88%, respectively; P<.05).
The mean length of stay in the rehabilitation center was 19 days among individuals with depression compared with 12 days among those without depression (P<.04); the failure rates were 32% and 10%, respectively (P<.02).
Dr. Ciocon said he conducted the study because he wanted to discover why certain patients did not perform as well or get discharged as quickly as others with the same diagnosis.
"Depression alone was the key," he told VerusMed. He added that it was important to screen patients in rehabilitation for depression so they could be assigned to see a psychologist or have their medications adjusted. (Poster A137.)
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