Self-Reported Versus Performance-Based Assessments of a Simple Mobility Task Among Older Adults in the Emergency Department - 14/12/17
Abstract |
Study objective |
Accurate information about the mobility of independently living older adults is essential in determining whether they may be safely discharged home from the emergency department (ED). We assess the accuracy of self-reported ability to complete a simple mobility task among older ED patients.
Methods |
This was a cross-sectional study of cognitively intact patients aged 65 years and older who were neither nursing home residents nor critically ill, conducted in 2 academic EDs. Consenting participants were asked whether they could get out of bed, walk 10 feet, turn around, and get back in bed without assistance, and if not, whether they could perform this task with a cane, walker, or assistance. Each participant was then asked to perform the task and was provided with a mobility device or assistance as needed.
Results |
Of 272 patients who met eligibility criteria and answered the physical task question, 161 (59%) said they could do the task unassisted, 45 (17%) said they could do it with a cane or walker, 21 (8%) said they could do it with assistance, and 45 (17%) said they would be unable to do it even with assistance. Among those who said they could do the task either with or without assistance and who were subsequently willing to attempt the task (N=172), discrepancies between self-reported ability and actual performance were common. Of those who said they could perform the task without assistance, 12% required some assistance or were unable to complete the task. Of those who said they could perform the task with a cane or walker, 48% required either assistance or were unable to perform the task. Of those who said they could perform the task with assistance, 24% were unable to perform the task even with assistance.
Conclusion |
In this sample of older adults receiving care in the ED, the accuracy of their self-reported ability to perform a simple mobility task was poor, particularly for those who reported some need for assistance. For older adults being considered for discharge who report a need for assistance with mobility, direct observation of the patient’s mobility by a member of the emergency care team should be considered.
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| Please see page 152 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Robert J. Zalenski, MD, MA |
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| Author contributions: KMR, GFP, and TFP-M conceived and designed the study. KMR supervised participant enrollment at UNC Chapel Hill. CWJ supervised participant enrollement at Cooper. VAB and SAM completed the literature review and enrolled participants. KMR, GFP, and TFP-M analyzed the data and drafted the manuscript, and all authors contributed substantially to its revision. TFP-M takes responsibility for the paper as a whole. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist and provided the following details: This work was supported by grants from the National Institute on Aging under a career development award (K23AG038548 to Dr. Platts-Mills) and a Medical Student Training in Aging Research award (5-T35-AG038047-03 to Mr. Roedersheimer). |
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| The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the University of North Carolina. |
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Vol 67 - N° 2
P. 151-156 - febbraio 2016 Ritorno al numero
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- Prospective Validation of the Ottawa 3DY Scale by Geriatric Emergency Management Nurses to Identify Impaired Cognition in Older Emergency Department Patients
- Laura Wilding, Debra Eagles, Frank Molnar, Jo-Anne O’Brien, William B. Dalziel, Joy Moors, Ian Stiell
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