| The purpose of this study was to explore the discharge patterns of patients with a diagnosis of stroke from the acute care setting. Previous studies have explored rehabilitation potential and/or acute care discharge patterns based on the patient's ability to perform self-care, which are called activities of daily living skills (ADLs). Previous studies have also explored caregiving and placement associated with the behavioral issues associated with dementia and brain injuries. This study explored the relationship of ADL functioning and behavioral issues to the discharge destination of patients in the acute care setting with a diagnosis of stroke. Data were gathered from the medical records of 200 patients sequentially admitted to a large university affiliated medical center. Data were gathered on demographics (age, gender, race, marital status), length of stay, ADL functioning (transfer, dressing, eating, toilet use, personal hygiene), behavior symptoms (wandering, verbal abuse, physical abuse, socially inappropriate/disruptive behaviors, resisting care) and discharge destination (home, rehabilitation facility, nursing home).; The results of the analyses revealed that there is a statistically significant difference in discharge destinations for length of stay, ADL functioning and behavior. For each additional day of admission in the hospital, the odds of discharge to nursing home are estimated to increase by 6.4%, when all other factors remain constant. For each additional increase in the total ADL score, the estimated odds of discharge to nursing home increase by 35.3%. The odds of being discharged to a nursing home are estimated to be 62 times higher for a patient exhibiting negative behaviors over a patient who does not exhibit those behaviors. There was no interaction found between ADL functioning and behavior for discharge destination. These results show that the patients who (1) remain as inpatients in the acute care setting for a longer period of time, (2) are more dependent in ADLs or (3) exhibit negative behaviors have increased odds of discharge to a nursing home. Employing behavioral interventions in the acute care setting to reduce negative behaviors may be a way to reduce nursing home placements for patients exhibiting negative behaviors. |
