Use of community support services by elderly patients discharged from general medical and geriatric medical wards

Abstract

This descriptive study examines the use of community support services by elderly persons discharged from general and geriatric medical wards of a large acute care British teaching hospital. A convenience sample of 40 patients were interviewed at 6-week intervals over a 3-month period about their need for and use of community support services. The type of ward from which patients were discharged did not influence the use of nursing, homemaker, physician, or warden/community visitor services, hospital day care, or meals-on-wheels. Patients who used the largest number of community services, and were the most frequent users of all available services, were those who, because of their fragility, died or were readmitted to hospital within 6 weeks of discharge. All families interviewed identified a need for more information about their elderly members' illnesses and prescribed medical regimes.

Discharge planning: issues and challenges for gerontological nursing. A critique of the literature

“…1987, Wachtel et al 1987, Jackson 1990, Naylor 1990) (see Figure 4). Of interest are the reports on the effect of patient medication education prior to discharge.…”

“…Most evaluations found are quantitative: decreases in number and frequency of patient care days, readmission rates, demand on post-discharge services, and scaling of patient and family satisfaction with the process (Schrager et al 1978, Cable & Mayers 1983, Rubenstein et al 1984, Marchette & Holloman 1986, Kennedy ef al. 1987, Wachtel et al 1987, Jackson 1990, Naylor 1990) (see Figure 4). Of interest are the reports on the effect of patient medication education prior to discharge.…”

Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review

“…Many studies from all over the world have repeatedly reported that many people who have been discharged from hospital to home, especially the elderly, encounter a variety of problems in the first weeks after their return home. Problems after discharge include dependence on others with regard to household activities [1-6], lower levels of independence in activities of daily living and self-care deficits [2,3,5-12], difficulty with reading medication labels or instilling eyedrops [13,14], not getting the help they needed [4,5,13,15-23], not being aware of available services [24-26], informational needs [4,13,26-30], symptom distress [28,31-33], social problems [34] and emotional problems as anxiety and uncertainty [7,29,35]. The post-discharge problems seem to be more common with increased age and in women [36] and may lead to further complications and unplanned hospital readmissions.…”

Discharge planning: an exploratory study

“…Tierney (1993) outlines some of the shortcomings of hospital discharge arrangements found in the literature. They include poor communication between hospital and community ( Skeet, 1975; Armitage & Williams, 1990; Williams & Fritton, 1991; Curran, 1992); inadequate notice of discharge ( Neill & Williams, 1992); over‐reliance on informal support and lack of statutory support ( Jackson, 1990; Williams & Fritton, 1991); inattention to patients’ needs before leaving hospital ( Neill & Williams, 1992); and wasted or duplicated visits by community nurses ( Armitage & Williams, 1990).…”