Integrated approach to prevent functional decline in hospitalized elderly: the Prevention and Reactivation Care Program (PReCaP)

To address this issue, the Vlietland Ziekenhuis in The Netherlands has implemented an innovative program (PReCaP), aimed at reducing hospital related functional decline among elderly patients by offering interventions that are multidisciplinary, integrated and goal-oriented at the physical, social, and psychological domains of functional decline.This paper presents a detailed description of the intervention, which incorporates five distinctive elements: (1) Early identification of elderly patients with a high risk of functional decline, and if necessary followed by the start of the reactivation treatment within 48 h after hospital admission; (2) Intensive follow-up treatment for a selected patient group at the Prevention and Reactivation Centre (PRC); (3) Availability of multidisciplinary geriatric expertise; (4) Provision of support and consultation of relevant professionals to informal caregivers; (5) Intensive follow-up throughout the entire chain of care by a casemanager with geriatric expertise. Outcome and process evaluations are ongoing and results will be published in a series of future papers.The Netherlands National Trial Register: NTR2317Hospital admission is considered a health risk for older patients. Thirty-five percent of 70-year old patients experience functional decline during hospital admission in comparison with pre-illness baseline. This percentage increases to 50% for 85-year old patients [1]. Functional decline in elderly patients is not necessarily related to the medical condition of the patient. Several other factors play a major role in the occurrence of the functional decline, including iatrogenic effects of the treatment and the effects of hospitalization, such as immobilization, isolation, and inaccessibility to fluids [2]. Furthermore, age, lower functional status before hospital admission, impaired cognitive status, depression and prolonged length of hospital stay are significant predictors of hospital related functional decline in elde