Maggie Killington
Repatriation General Hospital and Flinders University, Australia
Title: Hospital outreach rehabilitation following hip fracture repair for nursing home residents improves mobility outcomes: A single blind randomised control trial
Biography
Biography: Maggie Killington
Abstract
Question: Does “home rehabilitation” following hip fracture repair improve mobility for nursing home residents.
Design: Previously walking nursing home residents (n=240) with hip fractures received 4 weeks of home rehabilitation in their nursing home or usual care. In parallel, families and nursing home staff for the first 30 participants were invited to share their perceptions of the journey for residents at interviews/focus groups.
Intervention: Physiotherapy (minimum three sessions week for 4 weeks) focused on restoration of transfers and limited mobility.
Outcome measures: The Nursing Home Life Space Diameter (NHLSD), mobility status including level of independence and qualitative data organised as a thematic analysis with the assistance of NVivo 10 were collected.
Results: Nursing home residents who received “home rehabilitation” mobilised further and more frequently as assessed by the NHLSD (p < 0.0001). More “home rehabilitation” participants were reported to have regained independent mobility with a lower burden of care compared to usual care participants. Acute care staff struggled to provide people with dementia mobility retraining and nursing home staff were ill-equipped to provide post-operative care including mobility retraining and pain management on their return home.
Conclusion: Following hip fracture surgery “Home rehabilitation” for nursing home residents was feasible and improved independence with mobility was achieved.
Key Practice Points: 1. Strategies need to be developed to engage people who have dementia in early rehabilitation in the acute setting.
2. Mobile nursing home residents with dementia who fracture their hips can improve their mobility levels in response to outreach physiotherapy.