Evaluation of Restorative Care vs Usual Care for Older Adults Receiving an Acute Episode of Home Care

Abstract

Clinicians, policy makers, and older persons themselves increasingly acknowledge that a primary goal of health care for older, particularly multiply and chronically ill, persons should be to optimize function and comfort rather than solely to treat individual diseases.¹ With acknowledgment of this goal has come attempts to identify events that trigger functional loss and to develop methods that prevent or reverse this process.^2-5 Episodes of acute illness and hospitalizations are high-risk times for functional decline to occur. For example, between 25% and 50% of all hospitalized older persons experience loss of functional independence during hospitalization.^5,6 Only a third recover to prehospital levels of functioning by 3 months.⁷ Many older persons who decline during an acute illness or hospitalization are referred for home care services.^8,9 An episode of home care service thus represents a readily identifiable time for instituting interventions to improve functional outcomes.