TITLE:
Improvement of Activities of Daily Living (ADL) for Patients Treated in Skilled Nursing Facilities (SNFs)
AUTHORS:
Jaden A. Silver, Sean R. Silver
KEYWORDS:
Activities of Daily Living, Skilled Nursing Facilities, Rehabilitation, Independent Living
JOURNAL NAME:
Open Journal of Therapy and Rehabilitation,
Vol.12 No.1,
February
19,
2024
ABSTRACT: Background: Self-care tasks or activities of daily living (ADL)’s performance are
often disrupted after an older adult sustains an injury or illness, which can
be a determining factor for discharge placement after hospitalization, or it
can determine the level of assistance required after discharge from a skilled
nursing facility (SNF). We believe that comprehensive rehabilitation can
improve a patient’s overall functioning during their short term stay in SNFs.
The purpose of this study is to determine if an individual’s level of
independence improved after admission to a skilled nursing facility and
procurement of rehabilitation services. Methods: This study
retrospectively reviewed 4612 nursing home patients in California who underwent
rehabilitative services at skilled nursing facilities to determine how the
patients responded to their environments,
therapy interventions, and any other additional supportive measures. The
records of patients who were admitted for short-term rehabilitation were
reviewed in a blinded fashion, looking specifically at Section GG of the
Minimum Data Set (MDS). Self-Care Section GG scores recorded by rehabilitative
staff provide objective data and measure patients’ levels of assistance that
were required. Each activity is scored from 1, being completely dependent, to
6, being entirely independent, with varying levels of assistance with scores in
between. The admission scores versus the discharge scores can be compared to
determine if a patient improved their level of functioning upon discharge. Results: Utilizing the Pearson’s correlation coefficient, a strong correlation of
improvement in ADL performance on Section GG between the admission and
discharge scores was identified, implying significant improvement in functional
independence upon discharge. The average percent improvement for Managed Care
patients was ~35.4% and ~39.4% for Medicare patients. Conclusions: The
results support the benefits of rehabilitation services in skilled nursing
facilities, and the data suggests that admission scores can be used as a
predictive tool for functional outcomes.