Risky discharges: Are we too cautious?

Some elderly individuals choose to remain at home, despite considerable risks of injury or even death. We followed 19 patients who returned home despite all of the multidisciplinary team considering that they were extremely unsafe and at considerable risk. At six months, 10 (53%) were still at home, 5 (26%) were in rest homes, 1 (5%) was in long stay hospital care and 3 (16%) had died. The three patients who ''failed to manage'' at home, did so early (within one day), emphasising the importance of a ''trial leave'' period. Patients who lived with a carer were more likely to remain at home than those who lived alone (p=0.006). These findings suggest that very frail, ''at risk'', elderly patients can often manage at home despite considerable dangers.