A review of Short-Term, Community-Based, Slow-Stream Rehabilitation for older Patients Transitioning from Hospital to Home at Birr Community Nursing Unit

Abstract Background Hospitalisation has deleterious effects on older adults. 30-60% of hospital admissions experience hospital-associated disability and functional decline. Many older adults do not return to their pre-illness level of independence, even after one-year post-hospitalisation. Midlands Regional Hospital Tullamore (MRHT) is a large acute level 3 Hospital, the Midland Trauma, Oncology, Renal and Haematology centre. Since December 2023, a 6 bedded off site slow stream rehab was expanded in Birr CNU to meet the increased need of the acute hospital. This audit examines the use of this off site unit, and the outcome of rehabilitation. Methods Data was collected by the Rehabilitation team using an excel database. All patients admitted to the Rehabilitation beds between December 2023 and December 2024 were included. Results Of 67 referred to Birr for rehab, 36 patients were admitted. 31 from MRHT, 2 from St Luke’s Hospital Kilkenny, 2 from Midlands Regional Hospital Portlaoise and 1 from a nursing home convalescent setting. Diagnosis included: Stroke=14, Orthopedic=11, Medical=11. On admission 78% of patients were High/Maximum on barthel Index and 3% Low category. Average LOS 55 days (7 to 112 days). Average age 74 (59 to 93 years old). All (36) patients required physiotherapy, 35 required OT, and 18 required SLT. 75% of patients were discharged home, 19% went to Long term care, 1 patient died and 1 returned to hospital. 86% of patients required home visits. On discharge 19% of patients were in the High/ Maximum category and 53% were in the IND/Low category barthel index. Conclusion Birr takes the majority of referrals from MRHT. 75% admitted achieve home discharge. Rehabilitation improved independence using the barthel index. It worth noting, the number of admissions and length of stay may have been impacted by limited resources. Therefore, We need further resourcing of WTE to continue to develop this invaluable service.