Return to Community Living and Functional Ability Following Inpatient Rehabilitation for Hip Fracture in Patients Aged ≥65 Years: A Retrospective Descriptive Observational Study

Abstract

Objective

To determine the proportion of older patients who returned to their original homes after inpatient rehabilitation for hip fracture, focusing on prefracture living arrangements (living with family or alone), and to assess their activities of daily living (ADL) ability at discharge.

Design

A retrospective descriptive observational study.

Setting

An inpatient rehabilitation ward in Japan.

Participants

A total of 650 patients (108 men, 542 women; mean age 83.6±7.19y) aged ≥65 years who were admitted for rehabilitation after hip fracture surgery between 2016 and 2022 and had lived at home before injury were included in the analysis, after excluding those who were transferred to acute care hospitals due to medical complications.

Interventions

Not applicable (standard inpatient rehabilitation).

Main Outcome Measures

Discharge destination (returning home with family, returning to living alone, or transfer to a residential facility or long-term care hospital) and Functional Independence Measure (FIM) scores, including motor and cognitive subscores.

Results

Among 364 patients who had lived with family before injury, 317 (87.1%) returned home, including 1 who began living alone after discharge. Among 179 patients who had lived alone, 136 (76.0%) returned home. The median total FIM scores (range) were 107 (24-126) for those living with family and 109 (66-125) for those living alone. Approximately 18% of patients who returned to living with family had total FIM scores <80, whereas 26% of those who returned to living alone had scores below 100.

Conclusions

Although almost 90% of patients living with family and 3-quarters of those living alone returned home, a substantial proportion exhibited limited ADL ability, indicating a need for comprehensive care systems to support continued community living.