At the local hospital in Laerdal a geriatric team has been established since May 1991, and is organized as a project. Instead of a specialist in geriatrics the hospital has used a general practitioner with some geriatric experience and an interest in elderly patients. The team has also included a nurse, a physiotherapist and an occupational therapist. The services offered by the team have been well received by patients, general practitioners and other health workers in the region. It has now been decided that the team shall continue on a permanent basis from 1994.
In cooperation between the home care system in the Municipality of Rødovre and four hospital departments in the County of Copenhagen, a controlled and randomized investigation was undertaken among the hospitalized patients of 65 years and over from the Municipality of Rødovre. A nurse employed by the Municipality particularly for this project visited the hospital daily and followed the 135 participants in the intervention group with the objects of obtaining information from the primary sector if necessary, discussing discharge with the patient and the hospital staff, coordinating possible supportive measures in the patient's home and visiting the patient in his home immediately after discharge from hospital in order to ensure continuity in care and treatment. The 138 participants in the control group underwent the usual procedures in connection with admission to hospital. In this article, the consequences of the contributions by the health visitor in the hospital are described in relation to the course of hospitalization. The intervention group had an average stay in hospital of 11.0 days as compared with 14.3 days in the control group (p greater than 0.05), and the total number of bed-days were 1,490 and 1,970, respectively. In addition, the two groups were compared as regards the number of diagnostic procedures during hospitalization, the number of deaths, the diagnoses on discharge and the functional capacity. No differences were observed in these respects between the two groups. Three patients from the control group were discharged to residential institutions as compared with none in the intervention group.(ABSTRACT TRUNCATED AT 250 WORDS)
The aim of this randomized, controlled study was to evaluate a model for follow-up of patients aged 75 or more after discharge from hospital. One hundred and sixty-three patients from the intervention group were visited in their homes by a district nurse on the day after discharge from hospital and two weeks later by their general practitioner. For 181 control patients, discharge took place according to the usual procedures. One year after discharge 25 patients from the control group had been admitted to nursing homes compared to ten from the intervention group (p
Few studies describe and evaluate the use of ambulatory geriatric teams in nursing homes. This article gives an account of a model in which a multidisciplinary group from the local hospital has been visiting 17 communities in Norway twice a year for 11 years. The ambulatory geriatric team includes a geriatrician, a geriatric nurse, a physiotherapist and an occupational therapist. Their aim is to raise the quality of geriatric assessment and care and to enhance the cooperation between the hospital and the nursing homes in the communities. The team members are doing a comprehensive geriatric assessment of some of the patients; they assess cases for further referral, and examine patients with declining functioning with a view to rehabilitation. The team provides instruction in various aspects of geriatrics to community care professionals. Much time is devoted to discussions on problems raised by the staff, such as management of patients with dementia-related behavioural problems, and to provide feedback to staff-members. The team liaise between hospitals, nursing homes and community care services in the communities in order to enhance communication between the professionals involved. An evaluation of the team was done on behalf of the National Institute of Health through a postal questionnaire which was returned by 223 doctors, nurses and allied health care professionals. The results indicate that visits by the ambulatory team improve the knowledge of doctors and allied professionals about diseases in the elderly; 92% reported that they now felt they were doing a better job.
We studied the care of patients in homes for the elderly and in special homes for the demented in the city of Malmö. Nine district nurses were interviewed using a tape recorder, and the content of the interviews was analyzed. Many patients needed extensive care, and resources were insufficient regarding both number of staff and their competence. The management of nursing in the various districts of the city was not well-defined. More consulting time was requested on the part of both district nurses and general practitioners in homes for the elderly and homes for the demented.