An intermediate care unit for older people with both physical and psychiatric disorders: naturalistic outcome study.

BACKGROUND: An intermediate care unit opened in 2008 aiming to relieve pressure on beds in the local general hospital. Its goal was to provide rehabilitation for people recovering from physical illness who had coexisting psychiatric symptoms, including from delirium, but for whom assessment suggested that discharge home might be achieved. As an experimental unit, it warranted evaluation. We aimed to identify clinical factors associated with higher rates of discharge of the patients to their own homes. METHODS: A naturalistic retrospective exploratory cohort study of 100 consecutive admissions to the intermediate care unit. A backward logistic regression analysis was performed. RESULTS: Discharge home was associated with better scores on the Barthel Index of Activities of Daily Living at the time of discharge, a shorter duration of stay, and a psychiatric diagnosis other than delirium. CONCLUSIONS: At the time of pre-admission assessment, clinical factors which were likely to predict discharge home were unclear, suggesting a need for further studies to determine who might best benefit from this sort of intermediate care placement.

Developing an intermediate care unit for older people with mental and physical illnesses.

Intermediate care is an integral part of healthcare for older people with physical illness. It can provide rehabilitation and enable early hospital discharge, but people with both mental and physical illnesses have frequently been excluded from intermediate care services. This article describes a 12 bed, nurse led rehabilitation unit for older people with mental and physical health needs. The ethos is to promote independence and allow patients to achieve their objectives no matter what their age and ongoing limitations.