Adequacy of Discharge Plans and Rehospitalization among Hospitalized Dementia Patients

Abstract

Because of the rapid growth of the elderly population and the decreasing number of days that patients are able to remain in the hospital, the task of discharge planning has become increasingly critical and challenging. This article reports on a study undertaken to examine the adequacy of discharge plans developed for dementia patients and to investigate factors related to inadequate plan development and patient readmission. Study results suggest that a sizeable proportion of dementia patients are discharged without adequate aftercare plans and are at risk of rehospitalization. The findings of this study point to significant family and resource-related factors that compromise discharge plan adequacy for dementia patients. Implications for practice, education, and policy are discussed.

Evidence-based Risk Factors for Adverse Health Outcomes in Older Patients after Discharge Home and Assessment Tools: A Systematic Review

“…Indeed, a poor socioeconomic environment (Tyden, Hansen, Engstrom, Hedblad, & Janzon, 2002) including the receipt of social assistance, financial and insurance concerns, and living conditions in the home after discharge, most notably sub-optimal living conditions, were found to be risks associated with adversity. The lack of social support can put the elderly at risk for adverse health outcomes when released from an acute care facility (Cummings, 1999;Moser et al, 2005;Shipton, 1996;Weaver et al, 2006). There are a number of risk factors related to the support available identified in the present review.…”

“…One might wonder if treating depression would improve the other patient outcomes that are affected by depression. Cognitive impairment is another risk factor for adverse health events at discharge in the elderly population (Gray, Sager, Lestico, & Jalaluddin, 1998;Gray, Mahoney & Blough, 2001;1999;Pedone et al, 2005). It makes pain assessment more challenging to perform (Frondini, Lanfranchi, Minardi, & Cucinotta, 2007), making it more difficult to control physical pain.…”

“…Living alone and the availability of care after discharge were significant risk factors, as were caregiver depression, caregiver stress, and caregiver difficulty. One last factor related to the caregiver was having an unrealistic caregiver (Cummings, 1999). Caregiver availability and characteristics were noted, but so too was the interaction of caregiver stress and patient depression (Schwartz & Elman, 2003).…”

Patient perspective on care transitions after colorectal surgery

“…These are derived by the researcher(s) doing the theme extraction and reviewed for meaningfulness and consistency. The general flow of the overall analysis was as follows: (1) review of individual interviews; (2) identification of possible broad codes (noted on the transcripts) using the relevant codes reported by other investigators 15e19 ; these were finalized once most of the interviews was completed; (3) secondary analysis of all interviews applying the final set of codes and identification of relevant patient quotes that exemplified these codes; (4) subgroup analysis (i.e., male/female, readmitted/not Q1 readmitted, stoma/no stoma, and so forth); (5) regrouping of the codes into broader themes and domains; (6) comparison of the domains across patient subgroups (Table 2). This process was designed to construct theories that are grounded in the data themselves.…”

Palliative Care for Patients With Dementia in Long-Term Care

“…Transitions are the actions involved in coordination of care for patients as they move through the various settings in the health care system, and these play a major role in patient outcomes. [2][3][4] Increasing literature describes the challenges related to transitions, and characterizes points of high risk for patients. Interventions have been studied, published, and extrapolated successfully.…”