Transitional care programs are effective for improving patient outcomes upon discharge from acute care services and reducing the burden of healthcare costs; however, little is known about the types of transitional care programs for older adults across Canada. This exploratory study gathered an in-depth understanding of Canadian transitional care programs and described how each program functions to support older adults and family/friend caregivers. Nine key informants were interviewed about the development of transitional care programs within four Canadian provincial regions including Atlantic, Central, Prairie, and West Coast. Key facilitators and barriers influencing the development and long-term success of transitional care programs included program scope, program structure, continuity of care, funding, and health system infrastructure. Future research is required to identify how a broad range of transitional care programs operate and to disseminate knowledge with health leaders and decision-makers to ensure transitional care programs are embedded as essential health system services.
There is a knowledge gap about how the intersections of gender, race, culture, age, income, social class, and other identities shape Black women’s experiences of intimate partner violence (IPV). In this qualitative study, we utilized an intersectional approach to examine how IPV is experienced and managed by racialized women, and in particular, our focus was to explore the IPV experiences of Black Nova Scotian women in and beyond midlife and their experiences of seeking support. Participant recruitment was predictably challenging, but we were able to collect in-depth interview data from a Black woman who identified as being in and beyond midlife and who had experienced IPV in the past and from three people who provided support to Black women in a paid capacity. An interpretive narrative approach was utilized to identify five dominant themes: descriptions of the experiences of IPV for Black women; strategies for coping with IPV; strategies in supporting Black women experiencing IPV; barriers in accessing support; and challenges in the delivery of support. The knowledge gained through this research provides important insights about the experiences, barriers faced, and how to address these challenges for Black women who experience IPV in and beyond midlife.
It is often during transitions between health services that many issues arise for older adults, such as care that is poorly coordinated, additional burden placed on family and friend caregivers, and inappropriate placement in nursing homes. The Home Again program delivered by the provincial health authority in Nova Scotia, Canada, provides transitional care through providing additional support beyond what is normally provided through home care services to help older adults transition home after a hospital admission. The purpose of this research was to identify what factors contribute to older adults being placed unnecessarily in a nursing home when they could receive care through the Home Again program. Through using a retrospective multiple case study design, we analyzed interviews for five cases including older adult patients, their family or friend caregivers, and healthcare professionals in each case. Results indicate all hospitalized patients experienced a major health event or rapidly declining health. All family and friend caregivers experienced burnout and frustration from the lack of sufficient home care supports and quality of services available, such as services provided throughout the night. Healthcare professionals discussed that patients were placed on a waiting list for nursing homes due to lack of home care supports and resources for caregivers. This study contributes to our knowledge about better processes to ensure that hospitalized older adults are not unnecessarily admitted to nursing homes which can result in reduced healthcare costs and improved delivery and quality of care to older adults and their family and friend caregivers.
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