The future of rehabilitation for older Australians

In this issue of the Journal, Soh and colleagues report their study of the outcomes of inpatient rehabilitation for older people.¹ Their findings can
be interpreted in a variety of ways. Most participants (396 of 618, 60%) recovered pre-admission levels of functional performance (as measured with the Activities of Daily Living [ADL] scale), but cognitive impairment (64% of participants) and frailty (the median Clinical Frailty Score at admission was
6 = “moderately frail”) were confirmed as negative prognostic factors. Within three months of discharge from inpatient rehabilitation, 160 of the 618 had been newly institutionalised (26%) and 75 of the 693 initially included patients
had died (11%). Recovery of ADL function was, as expected, more frequent than recovery of the more complex functioning assessed by the Instrumental Activities of Daily Living scale (35%). But 110 of the 192 people living at home prior to admission who made no functional gains on the ADL during rehabilitation (57%) were still at home at the three-month follow-up and had probably received some benefit from the coordinated rehabilitation program. While the investigation by Soh and colleagues was a single centre study, their findings are broadly similar to those of an older Australian multicentre study.²