Factors Associated with a Label of Failure to Cope in Older Medical Inpatients: a Case-Control Study*

  • Alishya Burrell Western University
  • Saad Chahine Queens University
  • Laura L. Diachun Schulich School of Medicine & Dentistry, Western University, Centre for Education and Research Innovation, Schulich School of Medicine & Dentistry
Keywords: failure to cope, acopia, social admission, failure to thrive, older adults

Abstract

Background

The term failure to cope (FTC) is often used to dismissively describe hospitalized older adults. The purpose of this study was to identify the factors associated with receiving a label of FTC.

Methods

Age-matched, case-control study with electronic and paper chart review identifying patient characteristics and admis­sion details.

Results

One hundred eighty-five patients 70 years of age or older ad­mitted to a general medicine team over two years: 99 patients with the label of FTC and 86 controls. No patients labelled with FTC came from long-term care. Characteristics associ­ated with a label of FTC included living alone (aOR 3.8, 95% CI 1.9-7.8), falls (aOR 3.8, 95% CI 1.9-7.8), rehospitalization (aOR 3.6, 95% CI 1.7-8.0), and living in an independent dwell­ing (aOR 2.4, 95% CI 1.0-5.5). A higher number of chronic medications was associated with a lower likelihood of being labelled with FTC (aOR 0.9, 95% CI 0.8-1.0).

Conclusions

The results suggest that FTC is a label based predominantly on social factors and has no role in a medical assessment. The patient’s home setting was the key factor in being labelled with FTC, most medical factors did not play a significant role, and a pervasive language of blame was present.

Author Biographies

Saad Chahine, Queens University

Faculty of Education

Laura L. Diachun, Schulich School of Medicine & Dentistry, Western University, Centre for Education and Research Innovation, Schulich School of Medicine & Dentistry

Division of Geriatric Medicine, Department of Medicine

Published
2021-05-11
How to Cite
Burrell, A., Chahine, S., & Diachun, L. L. (2021). Factors Associated with a Label of Failure to Cope in Older Medical Inpatients: a Case-Control Study*. Canadian Geriatrics Journal, 24(2), 118-124. https://doi.org/10.5770/cgj.24.484
Section
Original Research