Hospital Discharge of Older Adults

Abstract

When an older adult is discharged from the hospital, she or he should have an individualized, comprehensive discharge plan to help prevent unnecessary complications and rehospitalization. But the large number of older adults who are hospitalized and their typically greater needs can make creating such a plan a challenge for clinicians. Clear communication among hospital personnel, patients, family members, case managers, and community caregivers (such as home health care nurses and long-term care staff) is essential. In examining effective discharge planning for this population, this article examines five discharge models.

Patients' Perceptions of Hospital Discharge Informational Content

“…Those having a prior hospitalization and those with a cardiac condition reported receiving a greater amount of discharge information than those experiencing a first admission or those with diagnoses other than cardiac. A prior admission conveys a sense of unsuccessful discharge planning, thereby prompting nurses to intensify instructional efforts (Hansen Bull, & Gross, 1998;Walker et al, 2007). Patients experiencing a first acute event may be at a point of uncertainty and struggling to cope at the time of hospital discharge rather than in a phase of information seeking and decision making about posthospital care (Decker et al, 2007;Jensen & Petersson, 2003), which may preclude extensive or even optimal discharge teaching.…”

“…A third interpretation could be that the use of standardized discharge planning protocols, including standardized discharge teaching plans with predefined content, ensures comprehensive discharge preparation (Mistiaen et al, 2007;Walker et al, 2007). These standard discharge teaching plans are often disease-condition-specific.…”

“…Planned preparation promotes timely discharge, anticipation of postdischarge needs and potential problems, continuity of care between hospital and home or community services (Jackson, 1994;Walker et al, 2007), and reduced rate of postdischarge complications and readmission (Mamon et al, 1992;Mistiaen, Francke, & Poot, 2007). To perform discharge preparation well, providers must accurately evaluate patients' needs for assistance early in the recovery period (Kleinpell, 2004;Reiley et al, 1996).…”

Planejamento da alta hospitalar do paciente diabético: construção de uma proposta

“…Furthermore, the patients doubts on any of the subjects (10,(14)(15) are identified and registered, as well as the information to whether there is a companion to receive instructions about the care, participate in the hospital discharge planning and perform the care at home after discharge (8,11,16) .…”

“…The nurse will certainly need to rely on the support of a multidisciplinary team to evaluate the patient, his or her care needs and to develop a joint therapy proposal (4,7,10,14,17) . There is a field on the proposed instrument to take note of the decisions reached in the team meetings for further reference in the discharge plan.…”