Burns Rehabilitation for the Elderly – Are We Doing Enough?

Yi-Chan Fan¹, Louisa Wardrope², Frank Li³

1 Concord Repatriation General Hospital, Concord NSW 2139, YiChan.Fan@health.nsw.gov.au

2 Concord Repatriation General Hospital, Concord NSW 2139 Louisa.Wardrope@health.nsw.gov.au

2 Concord Repatriation General Hospital, Concord NSW 2139 Frank.Li@health.nsw.gov.au

Background: 

It is well documented in literature that burns injuries in the elderly are associated with higher mortality, longer hospital stay, significant premorbid conditions compared to adults and children¹.  This is often associated with a deterioration in mobility and the need for inpatient rehabilitation.  As physiotherapists, it is important to assist this population in regaining function and facilitating discharge back home safely.  This research aims to identify whether our current physiotherapy service is adequate in assisting patients achieve their baseline mobility once their burns can be managed out of hospital.

Method:

A retrospective notes audit was conducted over a period of 18 months in 2015-2016 at Concord Repatriation General Hospital in elderly patients over the age of 65.  Data was collected on burns demographics, therapy frequency, premorbid function, length of time to reach baseline mobility and discharge destination.

Results:

Patients were generally seen 1-2 times daily by the burns physiotherapist on weekdays for mobility practice.  Out of the 47 patients who survived the burns injury, 38 patients (80.9%) achieved their baseline mobility prior to discharge, 9 patients (19.1%) were transferred to their local acute hospital for further medical management and only 3 patients (6.4%) were transferred to a rehabilitation unit.

Conclusion:

This research suggests that the current physiotherapy service provided at the CRGH burns unit is adequate in assisting the majority of patients with returning to baseline mobility.  Future therapy should focus on using functional and multidisciplinary outcome measures that identify geriatric burns patients who may benefit from more intensive therapy.

1. Middelkoop E, Vloemans AF. Response to Burns in the Elderly: What is Pathophysiology and What is Physiology?. EBioMedicine. 2015;2(10):1314–1315.

Biography:

I am a physiotherapist working at Concord Hospital Burns Unit.