Demography, disease, independence and polypharmacy of elderly social cases at SLH (DDIPS)

Abstract

Social cases in Malta are becoming a growing concern due to the large amount of bed space they occupy at the only main hospital in Malta. No studies whatsoever have ever been done in Malta regarding this population. A quantitative cross sectional study of all social cases at the main hospital was designed. The aims included: • Having basic statistics that could be compared with other studies done in other countries and which could be used as a reference for future studies. • The level of independence by using the Barthel index and an assessment of cognitive level by using the Abbreviated Mental Test. • To assess polypharmacy in this population and to view the prevalence of diseases. The results found that basic vital statistics are similar to other studies. The mean age was 80, 58.4% of social cases were female and most patients were found in medical wards. 66. 7 % were found to be highly dependent in AD Ls but surprisingly 10% were totally independent. 64% scored poorly on the AMT. When compared together it was found that 11. 7% of SC had a high level of independence in ADLs and scored well on the AMT. On the other hand 48% scored poorly on the AMT and were very dependent. Polypharmacy was found to be highly prevalent but the prevalence was still less than in other studies. Hypertension and vascular diseases were most prevalent and CVA gives the greatest risk of being a SC. Dementia as a disease was also found to be under diagnosed. Recommendations include the use of screening tests on admission to assess the dependence in ADLs and to find any cognitive impairment (these may pinpoint a potential SC), the better use of community services for independent SC, increase rehabilitation especially for SC with CV A and finally to expedite the transfer of highly dependent SC to long term facilities such as nursing homes.