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Figure. Factors Contributing to the Development of Hospitalization-Associated DisabilityGraphic Jump Location
Hospitalization-associated disability refers to patients who have a new disability in activities of daily living (ADLs) at hospital discharge that they did not have before the onset of the acute illness. This disability leads to the loss of independent functioning. It comprises patients who develop new disability between the onset of the acute illness and hospitalization, as well as those who develop new disability during their hospitalization. The risks for disability due to an acute illness before hospitalization and failure to recover functioning during hospitalization, as well as onset of a new disability during hospitalization, stem from the interaction of baseline functional reserve (vulnerability and capacity to recover), the precipitating event of the acute illness resulting in hospitalization, hospital processes that might contribute to disability, and factors affecting care after hospitalization discharge. Processes common to the development of geriatric syndromes include the interaction of baseline vulnerability and capacity to recover, the severity of precipitating events (acute illness), and care processes (hospital factors) that may inhibit functional recovery and promote further functional decline. IADLs indicate instrumental activities of daily living.
aIndicates that a new disability can occur at various points in the timeline between acute illness onset and hospital discharge.