[Rehabilitative short-term care (REKUP): acceptance and practicability of a new care concept].

Background: Rehabilitative short-term care (REKUP) is aimed at geriatric patients in need of rehabilitation but not (yet) capable of rehabilitation after acute inpatient hospitalization with a positive rehabilitation prognosis. It was tested at two geriatric rehabilitation clinics from October 2020 to March 2022.

Objective: Qualitative process evaluation with respect to acceptance (service providers, health insurance), adoption (implementation at the start of the project), practicability (processes, contents, structures) and observed patient satisfaction.

[Rehabilitative subacute inpatient care-Optimizing posthospital care for geriatric patients with rehabilitation needs: results of the REKUP study].

Background: Geriatric patients in subacute inpatient care (SC) with rehabilitation needs after hospitalization seldom utilize rehabilitative services and are often transitioned to long-term care (LTC), suggesting that their care in SC can be optimized.

Objective: To evaluate the effectiveness of rehabilitative subacute inpatient care (REKUP) in improving the care of geriatric patients in SC with rehabilitation needs after hospitalization.

Methods: The study was conducted as a nonrandomized intervention trial with an historical control group (CG).

[Rehabilitation needs of geriatric patients in subacute inpatient care after acute inpatient hospitalization-a neglected claim].

Background: Geriatric patients after hospitalization often utilize subacute inpatient care (SC); however, little is known about their care and further health status.

Objective: To identify persons in SC with rehabilitation needs and improvement potential after hospitalization and to describe the care, relevant parameters of the health status as well as use of medical/nursing services in and after SC.

Methods: After positive screening for previous hospitalization and need of rehabilitation with improvement potential in 13 nursing homes, the length of stay, therapeutic treatments and physician contacts in SC as well as functional parameters, pain, quality of life and the utilization of services according to the Social Security Code V (SGB V) and SGB XI were assessed at baseline, at the end and 3 months after SC.

[Health economic evaluation of rehabilitative short-term care : Analysis of the costs of geriatric patients with and without rehabilitative short-term care after inpatient hospital stay].

Background: Geriatric patients requiring rehabilitation and admitted to short-term care after an acute inpatient hospital stay seldom receive rehabilitative services later. Rehabilitative short-term care (REKUP) supplements short-term care with rehabilitative measures, aiming to prevent functional restrictions and long-term care.

Study Objective: To conduct a cost and cost-effectiveness analyses of REKUP and provide data for a nationwide rollout.

[Communication training MultiTANDEMplus – A contribution to improve communication between professional caregivers and physicians].

Background: Failures of communication between professional caregivers and physicians affect the quality of supply of nursing home residents.

Aim: As part of a model project it was aimed to develop a training for caregivers to improve communication and promote cooperation with physicians.

Methods: For the needs assessment as a basis to develop the training 56 professional caregivers and 40 physicians engaged in nursing home care answered questionnaires regarding their cooperation.

[Diabetes care and incidence of severe hypoglycemia in nursing home facilities and nursing services: The Heidelberg Diabetes Study].

Aim: The goal of this study was to perform a structured analysis of the treatment quality and acute complications of geriatric patients with diabetes mellitus (DM) cared for by nursing services and nursing home facilities. Secondly, structural problems and potentials for improvement in the care of multimorbid older people with DM treated by nursing homes and nursing services were analysed from the viewpoint of geriatric nurses, managers of nursing homes and general practitioners.

Methods: In all, 77 older persons with DM from 13 nursing homes and 3 nursing services were included in the analysis (76.

[Treatment quality in geriatric patients with diabetes mellitus in various home environments].

Objective: The goal of the present study was to systematically assess treatment quality, perceptions, and cognitive function of elderly patients with diabetes admitted to an acute geriatric hospital from different home environments (nursing home residents, home care, assisted living, family caregivers, self-sufficient).

Methods: Quality of diabetes treatment, metabolic control (HbA(1c)), nutrition, treatment satisfaction, cognition, disability, and level of dependency were assessed in 128 patients with diabetes.

Results: Out of 128 patients, 87 patients (68%) showed an HbA1c≤8% according to the guidelines for aging people with diabetes of the German Diabetes Association (DDG).

Improving care for patients with dementia hospitalized for acute somatic illness in a specialized care unit: a feasibility study.

Background: Persons with dementia hospitalized for an acute illness have a high risk of poor outcomes and add to the burden on acute care systems. We developed a segregated Special Care Unit (SCU) in a somatic hospital for patients with challenging behavior resulting from dementia and/or delirium. This pilot study evaluates the feasibility and patient outcomes.

A special care unit for acutely ill patients with dementia and challenging behaviour as a model of geriatric care.

This paper describes the development and management of a new model of care for hospitalized patients with challenging behaviour evoked by dementia and/or delirium. To ameliorate care for patients with dementia in a geriatric acute care hospital a segregated Special Care Unit for patients with challenging behaviour was created. Environmental features allow for safe and unrestricted ambulation within the unit and create a home-like atmosphere.

Hospitalizations during the last months of life of nursing home residents: a retrospective cohort study from Germany.

Background: To describe hospitalisations of nursing home (NH) residents in Germany during their last months of life.

Methods: Retrospective cohort study on 792 NH residents in the Rhine-Neckar region in South-West Germany, newly institutionalized in the year 2000, who died until the study end (December 2001). Baseline variables were derived from a standardized medical examination routinely conducted by the medical service of the health care insurance plans in Germany.

[Changes in needs for assistance and care after hip fractures in the elderly].

For the prevention and rehabilitation of fall-related fractures, not only functional status is important. It is necessary to describe the level of help and care needed at the time the fracture happened and its changes after a certain period. Investigations of the changes in the need of help and care after a fall-related fracture hardly exist for the Federal Republic of Germany.

[Causes for in-hospital treatment of nursing home residents].

The high rates of hospitalization in nursing home residents are as well known as the hazards of in-hospital treatment especially in this group of frail older people. Moreover, hospital admissions cause considerable costs. The objective of the study was to analyze why nursing home residents are admitted for in-hospital geriatric care, and to form hypotheses of how to prevent these admissions without loss of quality of care.

[Case management and functional outcome in persons aged 65 years and over with hip fracture].

The goal of the investigation was to study case management and functional outcome in older patients with hip fracture. A prospective observational survey was performed, including all patients aged 65 years and over presenting with hip fracture in Heidelberg, from 1 July 1999 to 30 June 2000. All patients were reassessed by telephone calls 6 months post-fracture.

A randomized trial of comprehensive geriatric assessment and home intervention in the care of hospitalized patients.

Objective: to prove the effectiveness of geriatric evaluation and management for elderly, hospitalized patients, combined with post-discharge home intervention by an interdisciplinary team.

Design: randomized controlled trial with outcome and costs assessed for 12 months after the date of admission.

Setting: university-affiliated geriatric hospital and the homes of elderly patients.

[Drug prescriptions and multiple falls in community-dwelling frail elderly subjects].

The purpose of the study was to identify associations between drug prescriptions and the risk of falls in community-dwelling frail elderly people. 360 frail elderly patients underwent a comprehensive geriatric assessment during hospital stay. After discharge, the home falls were recorded by a questionnaire during the follow-up year and a home visit was carried out at the end of the year.

Elderly patients' problems with medication. An in-hospital and follow-up study.

Objectives: To examine medication problems during a stay in hospital and after discharge and to identify risk factors that contribute to poor compliance with medication a prospective observational study was carried out in an university-affiliated geriatric hospital and a patients' home.

Patients: One hundred and nineteen patients admitted from home to the geriatric hospital underwent a comprehensive geriatric assessment. They were also tested in opening and removing tablets from various common medicine containers.

The Timed Test of Money Counting: a short physical performance test for manual dexterity and cognitive capacity.

The competent handling of money is an essential basis for living independently. Seventy-eight consecutively admitted patients to a geriatric hospital underwent the Timed Test of Money Counting (TTMC) which measures patients' ability to open a purse, take out all the money and count it. Further assessment included Mini-Mental State Examination (MMSE), Barthel Index of ADL, Self-maintaining and Instrumental Activities of Daily Living (IADL), grip strength and Williams' Board Test.

Effectiveness of hospital-based geriatric evaluation and management and home intervention team (GEM-HIT). Rationale and design of a 5-year randomized trial.

In this ongoing randomized controlled trial the effectiveness of an interdisciplinary team implementing hospital-based comprehensive geriatric assessment (CGA) and home intervention is being studied. All patients admitted from home showing functional decline with impairment of any basic activity of daily living are randomly assigned to one of the following courses of treatment: CGA with in-hospital and post discharge management by a home intervention team (HIT), where necessary (group 1): CGA with recommendations and usual care at home (group 2); or usual hospital and home care (group 3). The HIT consists of 3 nurses, 1 geriatrician, 1 physiotherapist, 1 occupational therapist, and 1 social worker.

[Social aspects in diagnosis and therapy of very elderly patients. Initial experiences with a newly developed questionnaire within the scope of geriatric assessment].

To evaluate social aspects of elderly patients which are important for diagnosis and therapy within geriatric assessment, a questionnaire was developed and validated. Raters showed a high degree of agreement on the scale, which contains social contacts and support, activities, economic situation, and housing conditions (0.92-0.

[The early rehospitalization of elderly patients. Causes and prevention].

The causes of early rehospitalization (within 3 weeks) of very elderly patients, its possible avoidance and appropriate preventive measures were analysed retrospectively in patients of a geriatric hospital. Included were all those patients who had been admitted to the hospital from their home several (mean: five) times between 1987 and 1990 (48 women, 19 men; mean age 81.3 +/- 7.