Identifying Cognitive Impairment in Hospitalized Older Adults to Prevent Readmission: Two Case Studies

Objective: To describe two patient outcomes post-discharge from an acute hospital admission. Both patients underwent cognitive testing during hospitalization. Methods: A battery of cognitive tests was administered to two hospitalized older adult patients. Both patients were evaluated in their homes within 72 hours of discharge and again at 14- and 30-days by a nurse practitioner. Results: One of the patients was readmitted within 30 days of hospital discharge due to complications from an amputation. This patient did not perform well on cognitive measures which may have been related to his pain levels and/or his medication regimen. Conclusions: Not all readmissions are avoidable; however, if readmissions are related to cognitive impairment, implementing strategies tailored to this population may reduce readmission rates. Clinical Implications: Risk factors for readmission should be identified so the discharge team can develop a tailored plan of care. Including both the patient and an informal caregiver may reduce the chance of a hospital readmission in older adults with cognitive impairment regardless of the etiology.