An Approach for Super-Elderly Patients With Heart Failure and Frailty in Community Hospital: DOPPO Rehabilitation

As referred to as the 2025 problem, the reduction of caregiver burden for elderly people is an urgent task. Our hospital is located in central part of Niigata City, and one of regional hospitals that provide several supports of caregiving for elderlies to return home after medical treatment. In the last year, 1343 medical patients were admitted to our hospital. Their mean age was 78 years. Aspiration pneumonia (15%) and congestive heart failure (10%) caused the majority of hospitalization. Over 80% of heart failure patients were octogenarians. Compared to patients aged under 80, these super-elderly patients had a lower ADL score, had a higher prevalence of cognitive disorder and malnutrition, regardless of cardiac function and BNP level. Except in-hospital death, only 25% cases could walk independently when discharged even if rehabilitation was performed. In other words, although management of heart failure is essential, how to improve ADL is key to return home. Meanwhile, since super-elderlies have risky comorbidities in silent, it is critical to manage the rehabilitation safely. From these points of view, we are proposing, an advance form derived from cardiac rehabilitation is the best way to improve the frailty of low ADL elderly in the presence or absence of heart failure. Now we are promoting DOPPO rehabilitation. As we have experienced 161 cases since 2013, here will report on the results and outcomes.