Recognizing hospital-acquired disability among older adults.

Approximately one third of hospitalized older adults develop a new disability by discharge, which places them at risk for readmission, institutionalization, and death. Various risk factors, both modifiable and nonmodifiable, coalesce in the acute care setting. As frontline health care providers, nurses are crucial to the process of altering modifiable risk factors by assessing patients’ risk for functional decline during hospitalization using a standardized instrument and treating risk with evidence-based interventions. Barriers to meeting this goal must be overcome, such as a lack of evidence to recommend use of one functional assessment tool over another, as well as the paucity of evidence-based interventions. Other obstacles such as the tacit acceptance of functional decline by health care providers and a lack of resources for mobilizing older adults contribute to the ongoing problem. Nurses are encouraged to develop new innovations to prevent the widespread and frequently untreated problem of hospital-acquired disability.