Functional Decline Predicts Emergency Department Use in Veterans With Dementia. (June 2014)

• Record Type: Journal Article
• Authors: Ng, Stephanie; Morgan, Robert O.; Walder, Annette; Biswas, Jonmenjoy; Bass, David M.; Judge, Katherine S.; Snow, A. Lynn; Wilson, Nancy; Kunik, Mark E.
• Is Part Of: American journal of Alzheimer's disease & other dementias. Volume 29:Number 4(2014)
• Page Start: 362
• Page End: 371
• Publication Date: 2014-06
• Subjects: dementia -- health services research -- activities of daily living -- medical services -- emergency; Alzheimer's disease -- Periodicals; Dementia -- Periodicals; Alzheimer's disease -- Patients -- Care -- United States -- Periodicals; 616.83
• DOI: 10.1177/1533317513518655
• Languages: English
• ISSNs: 1533-3175

Abstract

Background: We examined emergency room (ER) utilization by persons with dementia (PWDs) using caregiver and patient characteristics as predictors. Methods: A secondary analysis of 296 veteran–caregiver dyads. Caregivers recorded PWD baseline characteristics and noted ER visits over the next year. Two sets of regression models analyzed categorical ER use and repeat ER use. Results: In the univariate analysis, categorical use of the ER was predicted by patients' functional status ( P ≤ .008) and Veterans Affairs priority grouping ( P ≤ .02). Repeat ER admissions were predicted by functional status ( P ≤ .04), number of chronic conditions ( P ≤ .01), and caregiver-reported relationship strain ( P ≤ .04). In multivariate analysis, categorical ER use was predicted by functional status ( P ≤ .02), priority grouping ( P ≤ .03), and number of chronic conditions ( P ≤ .06). Conclusions: Functional status most strongly predicted ER use, highlighting the promise of home-based interventions to improve activities of daily living. Number of chronic conditions and caregiver-reported relationship strain are potential targets of intervention during discharge process.