Nursing & Primary Care


Functional and Cognitive Performances in a Geriatric Population in Home Care

Tagliabue Jacopo, Di Maio Giorgio, Mennillo Michele.

During 2018 the Home Care Unit takes care of 882 patients, with need of nurses and physiotherapists.

The aim of this study is to evaluate the functional and cognitive performances of our patient’s population. We evaluated the patients using: Barthel Index (BI), Mini Nutritional Assessment (MNA), Norton scale (NS), Clinical Dementia Rating Scale (CDR), pain evaluation with Numerical Rating Scale (NRS) or Pain Assessment in Advanced Dementia (PAINAD).

Results: male 398 (45.2%), female 484 (54.8%), mean age 80.1, BI 40.9, MNA 6.9, NS 14.1. The main pathology are: skin ulcers 359 patients (40.8%), orthopaedic disease 110 patients (12.5%), neurological disease 88 patients (10%), urinary disorders 53 patients (6%), neoplastic disease 45 patients (5.1%), cardiovascular disease 42 patients (4.8%).

The male vs female have statistically significant higher BI (44.1 vs 38.3) e NS (14.3 vs 13.8) (t-test p<0.05). 278 patients (31.5%) have pressure ulcers (PU), 604 patients have no PU.

194 patients (21.8%) have cognitive disorders (CDR≥2), 688 patients have no cognitive disorders (CDR<2). 88 patients with cognitive disorders (45.4%) have PU with chi-square statistically significant (P<0.05) if related to no cognitive disorders patients (27.6%). Patients with cognitive disorders have lower BI (13.5 vs 48.6) and NS (10.7 vs 15.1) non statistically significant. 88 patients with cognitive disorders (45.4%) have dysphagia with chi-square statistically significant (P<0.05) if related to no cognitive disorders’ patients (14.3%). No differences in pain evaluation or nutritional status.

Conclusion: the application of CDR permits to classify patients with cognitive disorders, who have a worse functional status with higher presence of pressure ulcers and dysphagia.

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