Search results for ‘Subject term:"older people"’ Sort:
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Adequacy of discharge plans for elderly patients
- Authors:
- MORROW-HOWELL N, PROCTOR Enola K, MUI Ada C.
- Journal article citation:
- Social Work Research and Abstracts, 27(1), March 1991, pp.6-12.
- Publisher:
- National Association of Social Workers
Describes a methodology for evaluating the outcome of discharge planning and for identifying patient and family factors and features of the discharge plans which contribute to success.
Discharge planning: best practice in transitions of care
- Author:
- PELLETT Candice
- Journal article citation:
- British Journal of Community Nursing, 21(11), 2016, pp.542-548.
- Publisher:
- MA Healthcare
- Place of publication:
- London
This article provides an overview of a project undertaken by the Queen's Nursing Institute (QNI) and funded by The Department of Health, to identify the barriers and challenges that prevent effective discharge from hospital to home. Unnecessary delays in discharging patients from hospital to home is an ongoing problem and for older people this can lead to worse health outcomes, which can increase their long-term care needs. Findings from the project illustrates that while there are challenges in achieving excellent practice in the transfer of a patient's care from hospital to home, there is a significant willingness and commitment from nurses based both in the community and hospital to improve the patient experience. Key recommendations are cited in the article that will enhance an improved discharge experience for patients, carers and their families. (Publisher abstract)
Key task 3: hospital discharges
- Authors:
- STATHAM Daphne, HARDING Tessa
- Journal article citation:
- Community Care, 28.1.93, 1993, p.17.
- Publisher:
- Reed Business Information
Elderly people are being discharged from hospital 'quicker and sicker' requiring more continuing care. Outlines procedures for discharge planning.
Experiences of elderly patients regarding participation in their hospital discharge: a qualitative metasummary
- Authors:
- LILLEHEIE Ingvild, et al
- Journal article citation:
- BMJ Open, 9(11), 2019, p.e025789. Online only
- Publisher:
- BMJ Publishing Group
Background: Ageing patients are discharged from the hospital ‘quicker and sicker’ than before, and hospital discharge is a critical step in patient care. Older patients form a particularly vulnerable group due to multimorbidity and frailty. Patient participation in healthcare is influenced by government policy and an important part of quality improvement of care. There is need for greater insights into the complexity of patient participation for older patients in discharge processes based on aggregated knowledge. Objective: The aim of this study was to review reported evidence concerning the experiences of older patients aged 65 years and above regarding their participation in the hospital discharge process. Methods: The study conducted a qualitative metasummary. Systematic searches of Medline, Embase, Cinahl, PsycINFO and SocINDEX were conducted. Data from 18 studies were included, based on specific selection criteria. All studies explored older patients’ experience of participation during the discharge process in hospital, but varied when it came to type of discharge and diagnosis. The data were categorised into themes by using thematic analysis. Results: The analysis indicated that participation in the discharge process varied among elderly patients. Five themes were identified: (1) complexity of the patients state of health, (2) management and hospital routines, (3) the norm and preference of returning home, (4) challenges of mutual communication and asymmetric relationships and (5) the significance of networks. Conclusions: Collaboration between different levels in the health systems and user-friendly information between staff, patient and families are crucial. The complexity of patient participation for this patient group should be recognised to enhance user involvement during discharge from hospital. Interventions or follow-up studies of how healthcare professionals can improve their communication skills and address the tension between client-centred goals and organisational priorities are requested. Organisational structure may need to be restructured to ensure the participation of elderly patients. (Edited publisher abstract)
Social work and transitions of care: observations from an intervention for older adults
- Authors:
- FABBRE Vanessa D., et al
- Journal article citation:
- Journal of Gerontological Social Work, 54(6), August 2011, pp.615-626.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Healthcare is often provided in a variety of different settings, making the transition between these, for example from hospital to home, challenging for many older adults. This article describes the third component of a multistage project in the US which developed and tested a telephone-based social work intervention for older adults (aged over 65 years) discharged from an acute care setting to home. This paper focuses on the third stage, a qualitative study looking at practice perspectives of the transition process. Interviews with three clinical social workers who managed 356 cases and their clinical notes were analysed to identify the salient themes; three were revealed. First despite some challenges and problems after discharge being potentially avoidable there were surprises that could not have been anticipated. Second, the social workers approached the cases with a broad and interconnected view of the health-care client system. Thirdly, relationship building between patients, care givers and providers, of both healthcare and other supportive services, was a key component of effective care transition. The authors suggest that the broad view taken by social workers, their training and their continuing relationship with their clients (often putting them in the right place at the right time) makes them suitable for developing and delivering models of care transition.
Buffer management to solve bed-blocking in the Netherlands 2000–2010. Cooperation from an integrated care chain perspective as a key success factor for managing patient flows
- Authors:
- MUR-VEEMAN Ingrid, GOVERS Mark
- Journal article citation:
- International Journal of Integrated Care, 11(3), 2011, Online only
- Publisher:
- International Foundation for Integrated Care
In The Netherlands, attempts were made to tackle the problem of bed-blocking in hospitals by using an Intermediate Care Department (ICD) as a buffer for bed-blockers. However, research has shown that ICDs do not sufficiently solve the bed-blocking problem and that bed-blocking is often caused by a lack of buffer management. This paper explains the theory of Buffer management (BM), a tool that endeavours to balance patient flow in the hospital to nursing home chain of care. It then draws on the results of recent explorative research which indicated that the absence of BM is not the result of providers’ thinking that BM is unnecessary, unethical or impossible because of unpredictable patient flows. Instead, BM is hampered by a lack of cooperation between care providers.
How family carers view hospital discharge planning for the older person with a dementia
- Authors:
- BAUER Michael, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 10(3), August 2011, pp.317-323.
- Publisher:
- Sage
In the context of research showing that discharge planning processes vary between hospitals and that some patients with dementia are discharged without adequate aftercare plans, this research looked at carers' experiences of the hospital discharge planning process for a family member with a dementia. A study funded by Alzheimer's Australia Research explored the question of whether caregivers who take responsibility for caring for a family member with dementia receive, as part of the hospital discharge planning process, the physical and psychosocial support they need to continue their caring role. This paper reports on one aspect of the study: family carers' perceptions of hospital discharge planning and preparation. 25 principal family carers of people with dementia were recruited in Victoria, Australia. The qualitative research involved semi-structured interviews about their experience of the preparation for and execution of hospital discharge, within 6 weeks of the patient's discharge from hospital. The article presents results of the analysis of the interviews, with examples. Analysis of the data indicated that the needs of family carers were not always addressed in the hospital discharge process and that discharge planning and execution needs improvement. Common concerns relating to discharge planning and preparation for older people with dementia and their family included: perceptions that discharge planning was ad hoc with no plan, lack of provision of information that family carers identified as important to their role, poor communication and information sharing between healthcare professionals and the family, and care provided to patients not meeting family members' expectations.
Relational practice as the key to ensuring quality care for frail older people: discharge planning as a case example
- Authors:
- WILLIAMS Sion, NOLAN Mike, KEADY John
- Journal article citation:
- Quality in Ageing, 10(3), September 2009, pp.45-55.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
Discharging frail older people from acute hospital settings has been an issue of concern for over 40 years and recent studies suggest that enduring problems remain. This paper explores the experiences of discharge from three different units: an acute surgical ward, an acute medical ward and a specialist ward for older people. Based on extensive data from interviews with older people, their family carers and ward-based staff, a grounded theory of the discharge experience is presented. This suggests that the quality of discharge hinges largely on whether the focus of efforts is on ‘pace’ (the desire to discharge older people as rapidly as possible) or ‘complexity’ (where due account is taken of the complex interaction of medical and wider social issues). When pace is the focus, ‘pushing’ and ‘fixing’ are the main processes driving discharge. However, when attention is given to complexity, far more subtle processes of ‘informing’ and ‘brokering’ are in evidence. These latter processes are conceived of as forms of ‘relational practice’ and it is argued that such practices lie at the heart of high quality care for older people.
Delayed transfer from hospital to community settings: the older person's perspective
- Authors:
- SWINKELS Annette, MITCHELL Theresa
- Journal article citation:
- Health and Social Care in the Community, 17(1), February 2009, pp.45-53.
- Publisher:
- Wiley
Prevention and management of delayed transfer of older people from hospital to community settings is an enduring issue in industrialised societies and is the subject of many recent policies in the United Kingdom. A deeper, evidence-based understanding of the complex organizational and interprofessional issues which contribute to delays in transfer has emerged in recent years. Despite this, and the relative success of recent policies, two recent reviews of the area highlight the lack of studies on patients' perspectives. This study sought to address this deficit by using conversational interviews and a phenomenological approach to explore and interpret participants' perceptions of delayed transfer from hospital into the community. A purposive sampling strategy was employed to incorporate participants from different categories of delay identified on weekly Situation Reports. Participants aged 65 years and over and with a mean delay of 32 days were recruited from three hospitals based in two NHS Trusts in the South of England. This paper focuses on their perceptions of the effects of delayed transfer into the community, their involvement in discharge planning and future community care needs. The findings show that participants actively or passively relinquished their involvement in the processes of discharge planning because of the perceived expertise of others and also feelings of disempowerment secondary to poor health, low mood, dependency, lack of information and the intricacies of discharge planning processes for complex community care needs. Participants expressed a longing for continuity, emphasised the importance of social contact and sometimes appeared unrealistic about their future care needs.
When it's time to go home
- Author:
- SHEPHERD Eileen
- Journal article citation:
- Nursing Times, 23.8.01, 2001, pp.22-23.
- Publisher:
- Nursing Times
Sending a patient home from hospital without the right support can be costly in human and financial terms. Looks at the importance of proper discharge planning, particularly for older people.