Older peoples' and informal caregivers' experiences, views, and needs in transitional care decision-making: a systematic review

Kraun, Lotan; Vliegher, Kristel De; Vandamme, Marie; Holtzheimer, Emilie; Ellen, Moriah; Achterberg, Theo van

doi:10.1016/j.ijnurstu.2022.104303

Cited by 22 publications

(40 citation statements)

References 56 publications

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“…Variation in transitional care decision‐making involvement preferences was identified in this study, implying that needs will also vary in this respect. Similar variation was also reported in other literature 9 , 11 , 31 highlighting the older people's and informal caregivers’ involvement needs and experiences. Further, a systematic review by Murray et al 32 identified levels of transitional care involvement ranging from ‘non‐involvement’ to ‘autonomous acting’.…”

Section: Discussionsupporting

confidence: 88%

“…Narrative data were collected from October 2020 to June 2021 using in‐depth, semistructured interviews. Two interview guides were developed (one for the interviews with older people and one for the interviews with informal caregivers) based on literature including a systematic review's findings 9 and according to the research team's expertise. The interview guides focused on topics such as involvement, autonomy, support and control in decision‐making before, during and after the transition but also encouraged the participants to raise relevant and related topics themselves.…”

Section: Methodsmentioning

confidence: 99%

“… 6 These transitions can have a major impact on older people's and informal caregivers’ daily lives due to feelings of confusion and powerlessness, as well as feelings of reduced autonomy when decisions are made on behalf of the older person. 7 , 8 , 9 , 10 , 11 There is an increasing need for more integrated care to cope with such challenges and for transitional care, more specifically. 9 , 12 , 13 , 14 The American Geriatrics Society has defined transitional care as ‘a set of actions designed to ensure the coordination and continuity of healthcare as patients transfer between different locations or levels of care within the same location’.…”

Section: Introductionmentioning

confidence: 99%

“… 7 , 8 , 9 , 10 , 11 There is an increasing need for more integrated care to cope with such challenges and for transitional care, more specifically. 9 , 12 , 13 , 14 The American Geriatrics Society has defined transitional care as ‘a set of actions designed to ensure the coordination and continuity of healthcare as patients transfer between different locations or levels of care within the same location’. 15 …”

Section: Introductionmentioning

confidence: 99%

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Transitional care decision‐making through the eyes of older people and informal caregivers: An in‐depth interview‐based study

Kraun

Achterberg

Vlaeyen

et al. 2023

Health Expectations

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Background Older people with multifaceted care needs often require treatment and complex care across different settings. However, transitional care is often inadequately managed, and older people and their informal caregivers are not always sufficiently heard and/or supported in transitional care decision‐making. Objective To explore older people's and informal caregivers' experiences with, views on, and needs concerning empowerment in transitional care decision‐making. Methods A qualitative descriptive study was conducted in the TRANS‐SENIOR consortium's collaborative research using semistructured in‐depth interviews between October 2020 and June 2021 in Flanders, Belgium. A total of 29 people were interviewed, including 14 older people and 15 informal caregivers who faced a transition from home to another care setting or vice versa. Data were analysed according to the Qualitative Analysis Guide of Leuven. Findings Five themes were identified in relation to the participant's experiences, views and needs: involvement in the decision‐making process; informal caregivers' burden of responsibility; the importance of information and support; reflections on the decision and influencing factors. Conclusions Overall, older people and informal caregivers wished to be more seen, recognised, informed and proactively supported in transitional care decision‐making. However, their preferences for greater involvement in decision‐making vary and are affected by several factors that are both intrinsic and extrinsic. Therefore, healthcare systems might seek out age‐tuned and person‐centred empowerment approaches focusing on older people's and informal caregivers' empowerment. For future studies, we recommend developing specific strategies for such empowerment. Patient or Public Contribution Older persons' representatives were involved in designing the TRANS‐SENIOR programme of research, including the current study. Healthcare professionals and nursing care directors were involved in the study design and the selection and recruitment of participants.

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Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transitional care decision‐making through the eyes of older people and informal caregivers: An in‐depth interview‐based study

Kraun

Achterberg

Vlaeyen

et al. 2023

Health Expectations

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“…At the same time, informal caregivers report unsatisfactory communication with the older person they care for, within their families, as well as with health professionals, all leading to hindered transitional care decision-making [ 8 ]. A focus on the empowerment of older people and informal caregivers in the transitional care decision-making thus becomes relevant [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Interventions for the empowerment of older people and informal caregivers in transitional care decision-making: short report of a systematic review

et al. 2023

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Background Care transitions across different settings necessitate careful decision-making for all parties involved, yet research indicates that older people and informal caregivers do not have a strong voice in such decisions. Objective To provide a systematic overview of the literature about interventions designed to empower older people and informal caregivers in transitional care decision-making. Design A systematic review (Prospero Protocol CRD42020167961; funded by the EU’s Horizon 2020 program). Data sources Five databases were searched: PubMed, EMBASE, Web of Science, PsycINFO, and CINAHL. Review methods The review included evaluations of empowerment in decision-making interventions for older people and informal caregivers facing care transitions, that were published from the inception of the databases up until April 2022. Data extractions were performed by two independent researchers and the quality of studies was assessed with the relevant JBI-critical appraisal tools. A narrative descriptive analysis of the results was performed. Findings Ten studies, reporting on nine interventions, and including a total of 4642 participants, were included. Interventions included transition preparation tools, support from transition coaches, shared decision-making interventions, and advance care planning. Designs and outcomes assessed were highly diverse and showed a mix of positive and lacking effects. Conclusions There is a lack of research on how to empower older people and their informal caregivers in transitional care decision-making. Empowerment in decision-making is usually not central in transitional care interventions, and effects on actual empowerment are mostly not assessed. Conclusions on how to empower older people and informal caregivers in transitional care decision-making cannot be drawn.

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Fundamentally shifting discharge planning and post-hospital care

Eskes,

Tobiano,

Carlini

et al. 2023

International Journal of Nursing Studies

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Older peoples' and informal caregivers' experiences, views, and needs in transitional care decision-making: a systematic review

Cited by 22 publications

References 56 publications

Transitional care decision‐making through the eyes of older people and informal caregivers: An in‐depth interview‐based study

Transitional care decision‐making through the eyes of older people and informal caregivers: An in‐depth interview‐based study

Interventions for the empowerment of older people and informal caregivers in transitional care decision-making: short report of a systematic review

Fundamentally shifting discharge planning and post-hospital care

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