Alternatives to Hospitalization for Frail Older Adults

​Despite preventive efforts, frail older adults continue to be highly susceptible to acute illness and geriatric syndromes (e.g., falls, delirium). But risks of hospitalization in these older adults include delirium, functional decline, falls, incontinence, and adverse drug reactions, and some of these risks remain high even in geriatric acute care units. Thus, efforts to manage acute illness in older adults should include identification and discussion of alternatives to hospitalization, and not exclusively preventive efforts, writes a physician in a commentary in the February 4, 2014, Annals of Internal Medicine. Physicians should help older adults identify their care goals, which may focus more on prolonging life, maintaining quality of life, or staying comfortable, the author writes. They should also discuss the risks and benefits of hospitalization with older adults and offer alternatives to hospitalization.