“They Don’t Trust Us”: The Influence of Perceptions of Inadequate Nursing Home Care on Emergency Department Transfers and the Potential Role for Telehealth

Abstract

In this descriptive, qualitative study, we conducted eight focus groups with diverse informal and formal caregivers to explore their experiences/challenges with nursing home (NH) to emergency department (ED) transfers and whether telehealth might be able to mitigate some of those concerns. Interviews were transcribed and analyzed using a grounded theory approach. Transfers were commonly viewed as being influenced by a perceived lack of trust in NH care/capabilities and driven by four main factors: questioning the quality of NH nurses’ assessments, perceptions that physicians were absent from the NH, misunderstandings of the capabilities of NHs and EDs, and perceptions that responses to medical needs were inadequate. Participants believed technology could provide “the power of the visual” permitting virtual assessment for the off-site physician, validation of nursing assessment, “real time” assurance to residents and families, better goals of care discussions with multiple parties in different locations, and family ability to say goodbye.

Family Communication in Long-Term Care During a Pandemic: Lessons for Enhancing Emotional Experiences

“…Although we know of no existing research on this in LTC settings, we would predict having residents with higher quality of life is likely to have positive influences on the quality of life of staff based on the theory of emotion contagion 16 . Better communication also makes for greater transparency between families and staff with potential benefits for improved health-care decision making 17 . The phone is a relatively easy form of communication to use without specialized technical skills, so staff may find this method the easiest to facilitate.…”

Design of an Interactive Two-Way Telemedicine Service System for Smart Home Care for the Elderly

“…Stephens et al mentioned that the main reasons that hinder the development of home-based services are insufficient funding and insufficient demand, and before its development is mature, it is still mainly provided by the government or governmental cooperative units, but home-based services can improve the quality of life of the elderly, enhance their sense of security, and also solve certain employment problems [15]. Chaet et al analysed the interview data through semistructured interviews with elderly people at home and used phenomenological research methods to extract five urgent main service needs of elderly people at home for integrated medical care services, such as general medical treatment, health management, health education, Chinese medicine for the treatment of diseases, and personalized health and should actively promote graded medical treatment [16].…”

Transitioning to Life in a Nursing Home: The Potential Role of Palliative Care

“…17,18 Improving access to PC would require education for providers in both acute and NH settings and improving NH staffing levels. 19 Given the effectiveness of PC consults in NHs 20 but the shortage of PC specialists, 21 telehealth, that is becoming increasingly familiar, accessible, acceptable, and reliable, has a promising role to connect NH residents and families to the care and support they need 22 and such care innovations need to be further explored.…”