Clinical Case Database / Category: Patient Management
Rehabilitation in a cognitively impaired patient
Lynn Poynter MBChB, MRCP, Michael Vassallo MD, FRCP (Lond), FRCP (Edin), DGM, MPhil, PhD (Soton)
Foundation Years Journal, volume 3, issue 9, p.24 (123Doc Education, London, November 2010)
Mrs EW, an 84-year-old woman, was admitted to the Emergency Department after being found on the floor by her home help. The patient had a past history of dementia and was at risk of falls. After initial management and investigation for possible causes of falls the patient wanted to go home. There were concerns raised about her safety by her daughter who wanted her mother to be admitted to a residential home. The focus of this case based discussion is on rehabilitation in patients with cognitive impairment and discharge planning.
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Lynn Poynter MBChB, MRCP
Specialist Registrar in Geriatric and General Medicine, Royal Bournemouth Hospital
Michael Vassallo MD, FRCP (Lond), FRCP (Edin), DGM, MPhil, PhD (Soton)
Consultant Physician and Foundation Programme Director
in Royal Bournemouth Hospital and Honorary Senior Clinical Lecturer
in Southampton University
1. Hoenig H, Rubenstein L. Hospital associated deconditioning and dysfunction. (Editorial). Journal of the American Society of Geriatrics. 1991, 39:220â€“222.
2. Creditor M. Hazards of hospitalization of the elderly. Annals of Internal Medicine. 1993, 118(3):219â€“223.
3. Hirsch C, Sommers L, Olsen A, Mullen L, Winograd C. The natural history of functional morbidity in hospitalized older patients. Journal of the American Society of Geriatrics. 1990, 38:1296â€“1303.
4. Cameron ID, Kurrie SE. Rehabilitation and Older People. The Medical Journal of Australia, 2002, 177:387â€“391.
5. Cahill S, Dooley A. The historical context of rehabilitation and its application to dementia care. In Marshall M. (ed.) Perspectives on Rehabilitation and Dementia. London, Jessica Kingsley 2005.
6. Rubenstein L, Wieland D. et al. The Sepulveda VA Geriatric Rehabilitation Unit: data on 4 year outcomes and predictors of improved patient outcomes. Journal of the American Geriatric Society, 1984, 32:503â€“512.
7. Friedman PJ, Baskett JJ, Richmond DE. Cognitive Impairment and its Relationship to Gait Rehabilitation in the Elderly. New Zealand Medical Journal, 1989, November 22, 102(880):603â€“606.
8. Caradoc-Davies T. Medical profiles of patients admitted to a geriatric assessment and rehabilitation unit. New Zealand Medical Journal, 1987, 9(100):557â€“559.
9. Stahelin H. Cognitive prerequisites of geriatric rehabilitation. Z Gerontol Geriatr, 2000, 33(S1):24â€“27.
10. Pomeroy V, Warren C, Honeycombe C. Mobility and dementia: Is physiotherapy treatment during respite care effective? International Journal of Geriatric Psychiatry, 1999, 14:389â€“397.
11. Resnick B, Daly M. Predictors of functional ability in geriatric rehabilitation patients. Rehabilitation Nursing, 1998, 23(1):21â€“29.
12. Landi F, Bernabei R, Russo A et al. Predictors of Rehabilitation outcomes in frail patients Treated in a Geriatric Hospital. Journal of the American Geriatrics Society, 2002, 50:679â€“684.
13. Johnson M, Kramer A, Lin M, Kowalsky J, Steiner J. Outcomes of older persons receiving rehabilitation for medical and surgical conditions compared with hip fracture and stroke. Journal of the American Geriatrics Society, 2000, 48(11):1389â€“1397.
14. Diamond PT. et al. Effect of cognitive impairment on rehabilitation outcome. American Journal of Physical Medicine and Rehabiliation, 1996, 75(1):40â€“43.
15. Barnes C, Conner D, Legault L, Reznickova N, Harrison-Felix C. Rehabilitation outcomes in cognitively impaired patients admitted to skilled nursing facilities from the community. Archives of Physical Medicine and Rehabilitation, 2004, 85(10):1602â€“1607.
16. Yu F, Richmond T. Factors Affecting Outpatient rehabilitation Outcomes in Elders. Journal of Nursing Scholarship, 2005, 37(3):229â€“236.
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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