163 Rehabilitation to Nursing Home - The Waiting Period

Abstract

Abstract Background The average application processing time for the National Nursing Home Support Scheme (NHSS) has seen drastic improvement from 15 weeks in 2014 to 4 weeks in 20161. There is no available data of the duration of stay in rehabilitation beds after approval of NHSS application and reasons for delay in transition to nursing home. Aims (1) To examine average length of stay in rehabilitation before multidisciplinary team (MDT) decision is made for nursing home care. (2) To examine average length of stay in rehabilitation bed from the time of NHSS approval to discharge into nursing home. (3) To examine reasons for delay in discharge to nursing home after NHSS approval. Methods A retrospective chart review of patients discharged into nursing homes between January to June, 2018 from geriatric rehabilitation units. Data collected include age, length of stay in rehabilitation unit before multidisciplinary decision was made in conjunction with patients/family to seek nursing home care (LOS1), Length of stay in rehabilitation bed following decision for nursing home care (LOS 2). Reasons for the delay in the transition from rehabilitation bed to nursing home bed were also documented. Results Seventeen patients were discharged into nursing homes, LOS1 of 43.12 days and LOS2 of 50 days. Complexity of application in terms of financial evaluation especially for patients who were deemed cognitively incapable of managing their finances, lack of suitable nursing homes for patients with complex needs/challenging behaviours, family dynamics with regards to choice of nursing homes and medical stability to facilitate such transfers were reasons for delay in transition to nursing home beds. Conclusion Transitional care beds, which are generally acknowledged to be more appropriate to these patients' care needs and are less expensive than rehabilitation beds, need to be utilized more. Education of healthy adults over 65 years to proactively plan for future care needs and promote awareness of legislatures regarding capacity and decision making.