Older persons’ experiences of adapting to daily life at home after hospital discharge: a qualitative metasummary

Abstract

Background Researchers have shown that hospitalisation can decrease older persons’ ability to manage life at home after hospital discharge. Inadequate practices of discharge can be associated with adverse outcomes and an increased risk of readmission. This review systematically summarises qualitative findings portraying older persons’ experiences adapting to daily life at home after hospital discharge. Methods A metasummary of qualitative findings using Sandelowski and Barroso’s method. Data from 13 studies are included, following specific selection criteria, and categorised into four main themes. Results Four main themes emerged from the material: (1) Experiencing an insecure and unsafe transition, (2) settling into a new situation at home, (3) what would I do without my informal caregiver? and (4) experience of a paternalistic medical model. Conclusions The results emphasise the importance of assessment and planning, information and education, preparation of the home environment, the involvement of the older person and caregivers and supporting self-management in the discharge and follow-up care processes at home. Better communication between older persons, hospital providers and home care providers is needed to improve the coordination of care and facilitate recovery at home. The organisational structure may need to be redefined and reorganised to secure continuity of care and the wellbeing of older persons in transitional care situations. Electronic supplementary material The online version of this article (10.1186/s12913-019-4035-z) contains supplementary material, which is available to authorized users.

What matters when asking, “what matters to you?” — perceptions and experiences of health care providers on involving older people in transitional care

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Nurses' experiences of transitions of older patients from hospitals to community care. A nation‐wide survey in Norway

“…These problems include incomplete exchange of information between healthcare providers and greater challenges in managing and coordinating care delivery to ensure optimal outcomes 11,12 . Older people in need of care still experience poor quality transitions from hospital to community care, increasing the risk for needs at home not being met and subsequent early readmission to hospital, or unwanted permanent placement in residential care 13,14 …”

Development of an informational support questionnaire of transitional care for aged patients with chronic disease

“…12 13 However, some researchers have pointed out that aged patients with chronic diseases who received transitional care are still adversely affected as a result of low intensity of information support in transitional care. [14][15][16] These patients, who are repeatedly transferred from hospitals to their homes often do not get high-quality information support; resulting Open access in a poor quality of continuing care, especially in medication information and discharge plan implementation. [17][18][19][20] Therefore, for this special vulnerable group, we need to ensure high-intensity information support in carrying out their transitional care.…”