Informal Support For Older Adults: Is It Associated With Hospitalization Processes?

Mobility and nutrition during acute hospitalization have long-term consequences on older adults’ functioning, yet their performance remains poor. Instrumental support provided by family members or friends during hospitalization is highly prevalent, as up to 77–96% of older adults are accompanied by informal caregiver. The effect of this support on mobility and nutritional intake is yet to be determined. Current investigation used prospective cohort of 493 independent (modified Barthel index≥80) older adults hospitalized in internal medicine units and participated in the Hospitalization Process Effects on Functional Outcomes and Recovery prospective cohort study. Data on mobility (staying inside the room vs. mobility outside the room) and the proportion of daily caloric intake was collected through interviews during 3 consecutive hospitalization days, using validated questionnaires. Informal support with mobility and eating was assessed with relevant items from the Informal Caregiving for Hospitalized Older Adults scale. Mean proportion of daily caloric intake was 0.6 (SD=0.2), and one third (146, 30%) of the participants stayed in the room during the hospitalization. Multivariate regression showed that informal support was negatively associated with mobility (OR for staying in the room vs. walking outside=1.87, 95%CI=1.09–3.19) and eating (beta=-.088, 95%CI=(-0.133)-(-0.002)), controlling for age, gender, severity of illness, comorbidity, length of stay, anxiety symptoms, risk for malnutrition and pre-hospital mobility. This association between informal support and unfavorable hospitalization processes suggests the importance of routine functional assessment and tailored counseling of informal caregivers to meet older patients’ support needs.