The impact of acute hospitalization on older persons Experiences, outcomes and improvements

For older persons, acute hospitalization is considered to be a high risk-event as older individuals are at great risk for adverse outcomes, including functional decline, readmission, and mortality. The overall aim of this thesis was to work towards better postdischarge outcomes. First, we aimed to improve the hospital discharge process, which forms the basis of a safe transition from hospital to home. To aid professionals to provide adequate follow-up care during the critical months postdischarge and to inform future interventions that help improve postdischarge functioning, our second aim was to characterize older patients’ perspectives on the postdischarge period. Our third objective was to gain insight into the course of geriatric syndromes from admission until the three months postdischarge and their association with adverse outcomes. This thesis shed light on the importance of a safe transition from hospital to home. Future interventions should continue to create awareness of the importance of a proper discharge process and the importance of adequate follow-up care. Given that adverse outcomes seem to be rooted in patients’ vulnerable health status, accurate follow-up care should start with comprehensive geriatric assessment (CGA) during admission and communication on the presence of geriatric syndromes to the following care provider. Then, to ensure continuity of care, it seems essential to initiate transitional care that further builds on the CGA treatment plan. That way, unnecessary readmissions can be prevented, functional recovery can be stimulated and, if needed, timely advance care planning can be initiated.