Hospital to home : family caregiver perspectives of discharge transitions of seniors with dementia

Hospital discharge transitions can be challenging for seniors and their caregivers. Seniors with dementia are particularly vulnerable and are at increased risk for adverse outcomes from poorly executed hospital to home discharge transitions. Family caregivers play a vital role in supporting seniors with dementia by coordinating care among healthcare providers across the continuum of care. Research suggests there is significant opportunity for improvement in hospital discharge processes to ensure that patients with dementia and their family caregivers are prepared to resume care at home after hospital discharge. Family caregivers of hospitalized patients with dementia continue to report unmet needs and the extent to hospital discharge interventions are provided and how they are perceived by family caregivers of patients with dementia is unknown. Guided by Meleis’ middle-range theory of transitions, a critical incident technique study was designed to explore family caregiver perceptions of the hospital discharge process for seniors with dementia. Five categories of healthcare provider activities were identified as important to the hospital discharge process for persons with dementia. Providing person-centered dementia care involved recognizing dementia in the patient and the importance of taking a different approach. Getting on the same page emphasized the crucial role of communication and involved seeing a capable person and knowing the plan. Caregivers expressed concern for Maximizing function and strong enough to go home. Managing medications was critical to ensure behavioral symptoms of dementia were well managed. Post-discharge support involved getting needed information, arranging for services after discharge, and calling for help. These categories are consistent with the literature regarding hospital to home discharges for seniors and their caregivers. Family caregivers of hospitalized patients with dementia have additional needs beyond those of typical patients and collaboration with healthcare providers is vital to ensure patient needs are met. These findings highlight the importance of person-centered care delivery so that hospital discharge processes are tailored to the unique circumstances of each patient and caregiver.