Skip to main content
×
Home

Experiences of Older Adults in Transition from Hospital to Community*

  • Elena Neiterman (a1), Walter P. Wodchis (a2) (a3) (a4) and Ivy Lynn Bourgeault (a5) (a6) (a7)
Abstract
ABSTRACT

This study examined how patients experience transitions to community from hospitals, inclusive of daily living problems and medical concerns. Analysing qualitative data from interviews with 36 individuals including 17 high-risk older adults with multiple chronic health conditions recently discharged from hospital, and 19 family members who provided the patients with ongoing care, we asked (1) What are the challenges that patients experience in transitioning home from the hospital, and (2) What are the system and policy solutions that can address the challenges these patients experience? Our findings reveal both short- and long-term challenges associated with transitions back home. Short-term challenges include preparing the dwelling for the patient and understanding the organization of care at home. Long-term challenges are associated with practical and emotional concerns. Reflecting on our findings, we suggest that patients’ social needs may be equally important to their medical needs during post-discharge recovery, and we discuss implications for policy.

RÉSUMÉ

Cette étude a examiné comment les patients éprouvent des transitions à la communauté des hôpitaux, y compris les problèmes de la vie quotidienne et les préoccupations médicales. Grâce à l'analyse de données qualitatives à partir d'entretiens avec 36 personnes, y compris 17 adultes âgées à haut risque avec des problèmes multiples de santé chroniques, récemment sortis de l'hôpital, et 19 membres de la famille qui ont fourni les patients avec des soins continus, nous avons demandé (1) quels sont les défis que les patients éprouvent dans la transition de l'hôpital, et (2) quelles sont les solutions de systèmes et politiques qui peuvent répondre aux défis que ces patients éprouvent? Nos résultats révèlent des défis à court et a long terme associés aux transitions à la maison. Les défis à court terme comprennent la préparation de l'habitation pour le patient et la compréhension de l'organisation des soins à la maison. Les défis à long terme sont associés à des problèmes pratiques et émotionnels. Réfléchissant sur nos résultats, nous suggérons que les besoins sociaux des patients peuvent être d'une importance égale à leurs besoins médicaux lors de la récupération post-décharge, et nous discutons les implications pour la politique.

Copyright
Corresponding author
La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Elena Neiterman, Ph.D. Assistant Professor Department of Sociology McMaster University 1280 Main St. W. Hamilton, ON L8S 4M4 (neitee@mcmaster.ca)
Footnotes
Hide All
*

This research was supported with funding from the Health System Performance Research Network (of which Walter Wodchis is the principal investigator) and supported in part by grants from the Ontario Ministry of Health and Long-Term Care. The opinions, results, and conclusions are those of the authors with no endorsement by the Ontario Ministry of Health and Long-Term Care. We would also like to thank Kate Leslie for her support in conducting the interviews.

Footnotes
References
Hide All
Altfeld S. J., Shier G. E., Rooney M., Johnson T. J., Golden R. L., Karavolos K., et al. (2013). Effects of an enhanced discharge planning intervention for hospitalized older adults: A randomized trial. The Gerontologist, 53(3), 430440.
Arbaje A. I., Wolff J. L., Yu Q., Powe N. R., Anderson G. F., & Boult C. (2008). Postdischarge environmental and socioeconomic factors and the likelihood of early hospital readmission among community-dwelling Medicare beneficiaries. The Gerontologist, 48(4), 495504.
Borthwick R., Newbronner L., & Stuttard L. (2009). ‘Out of Hospital’: A scoping study of services for carers of people being discharged from hospital. Health and Social Care in the Community, 17(4), 335349. doi: 10.1111/j.1365-2524.2008.00831.x
Boughton M., & Halliday L. (2009). Home alone: Patient and carer uncertainty surrounding discharge with continuing clinical care needs. Contemporary Nurse, 33(1), 3040.
Charmaz K. C. (2006). Constructing grounded theory: A practical guide through qualitative analysis. London, UK: Sage.
Coleman E. A. (2003). Falling through the cracks: Challenges and opportunities for improving transitional care for persons with continuous complex care needs. Journal of American Geriatric Society, 51(4), 549555.
Coleman E. A., & Berenson R. A. (2004). Lost in transition: Challenges and opportunities for improving the quality of transitional care. Annals of Internal Medical, 141(7), 533536.
Coleman E. A., Parry C., Chalmers S., & Min S. J. (2006). The care transitions intervention – Results of a randomized controlled trial. Archives of Internal Medicine, 166(17), 18221828.
Driscoll A. (2000). Managing post-discharge care at home: An analysis of patients’ and their carers’ perceptions of information received during their stay in hospital. Journal of Advanced Nursing, 31(5), 11651173.
Dunnion M. E., & Kelly B. (2005). From the emergency department to home. Journal of Clinical Nursing, 14(6), 776785.
Efraimsson E., Sandman P. O., Hydén L. C., & Rasmussen B. H. (2006). How to get one’s voice heard: The problems of the discharge planning conference. Journal of Advanced Nursing, 53(6), 646655.
Fabbre V. D., Buffington A. S., Altfeld S. J., Shier G. E., & Golden R. L. (2011). Social work and transitions of care: Observations from an intervention for older adults. Journal of Gerontological Social Work, 54(6), 615626.
Garcia-Caballos M., Ramos-Diaz F., Jimenez-Moleon J. J., & Bueno-Cavanillas A. (2010). Drug-related problems in older people after hospital discharge and interventions to reduce them. Age and Ageing, 39(4), 430438.
Glasby J., Martin G., & Regen E. (2008). Older people and the relationship between hospital services and intermediate care: Results from a national evaluation. Journal of Interprofessional Care, 22(6), 639649.
Graham C. L., Ivey S. L., & Neuhauser L. (2009). From hospital to home: Assessing the transitional care needs of vulnerable seniors. The Gerontologist, 49(1), 2333.
Henwood M. (2006). Effective partnership working: A case study of hospital discharge. Health and Social Care in the Community, 14(5), 400407.
Howell S., Silberberg M., Quinn W. V., & Lucas J. A. (2007). Determinants of remaining in the community after discharge: Results from New Jersey’s nursing home transition program. The Gerontologist, 47(4), 535547.
LaMantia M. A., Scheunemann L. P., Viera A. J., Busby-Whitehead J., & Hanson L. C. (2010). Interventions to improve transitional care between nursing homes and hospitals: A systematic review. Journal of the American Geriatrics Society, 58(4), 777782.
McKenna H., Keeney S., Glenn A., & Gordon P. (2000). Discharge planning: An exploratory study. Journal of Clinical Nursing, 9(4), 594601.
Naylor M. (2012). Advancing high value transitional care: The central role of nursing and its leadership. Nursing Administration Quarterly, 36(2), 115126.
Perry M., Hudson H. S., Meys S., Norrie O., Ralph T., & Warner S. (2012). Older adults’ experiences regarding discharge from hospital following orthopaedic intervention: A metasynthesis. Disability and Rehabilitation, 34(4), 267278.
Regen E., Martin G., Glasby J., Hewitt G., Nancarrow S., & Parker H. (2008). Challenges, benefits and weaknesses of intermediate care: Results from five UK case study sites. Health and Social Care in the Community, 16(6), 629637.
Rockwell J. (2010). Deconstructing housework: Cuts to home support services and the implications for hospital discharge planning. Journal of Women & Aging, 22(1), 4760.
Tomura H., Yamamoto-Mitani N., Nagata S., Murashima S., & Suzuki S. (2011). Creating an agreed discharge: Discharge planning for clients with high care needs. Journal of Clinical Nursing, 20(34), 444453.
van Walraven C., Dhalla I. A., Bell C., Etchells E., Stiell I. G., Zarnke K., et al. (2010). Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. Canadian Medical Association Journal, 182(6), 551557.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Canadian Journal on Aging / La Revue canadienne du vieillissement
  • ISSN: 0714-9808
  • EISSN: 1710-1107
  • URL: /core/journals/canadian-journal-on-aging-la-revue-canadienne-du-vieillissement
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 16
Total number of PDF views: 136 *
Loading metrics...

Abstract views

Total abstract views: 532 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 21st November 2017. This data will be updated every 24 hours.