An Examination of Family Caregiver Experiences during Care Transitions of Older Adults

Abstract

This study explored informal family caregiver experiences in supporting care transitions between hospital and home for medically complex older adults. Using a qualitative, grounded-theory approach, in-depth semi-structured interviews were conducted with community and resource case managers, as well as with informal caregivers of older hip-fracture and stroke patients, and of those recovering from hip replacement surgery. Six properties characterizing caregiver needs in successfully transitioning care between hospital and home were integrated into a theory addressing both a transitional care timeline and the emotional journey. The six properties were (1) assessment of unique family situation; (2) practical information, education, and training; (3) involvement in planning process; (4) agreement between formal and informal caregivers; (5) time to make arrangements in personal life; and (6) emotional readiness. This work will support research and clinical efforts to develop more well-informed and relevant interventions to most appropriately support patients and families during transitional care.

Understanding informal carers’ experiences of caring for older people with a hip fracture: a systematic review of qualitative studies

“…You know, work, making sure things were taken care of with his household, my household, visiting him every day…so, trying to juggle everything was probably the most difficult thing" [36 p.5]. Additional stress and complication were sorting out and co-ordinating the roles of other family members involved in providing care [32,40,41,[43][44][45]; or living a significant distance away [41,45].…”

Understanding patient and relative/carer experience of hip fracture in acute care: A qualitative study protocol

“…Some studies identified that carer's burden and needs change during different phases of recovery (Giosa et al, 2014). The burden was greatest after surgery and decreased over time with a satisfactory recovery and when carers had a better knowledge about their own role (Giosa et al, 2014;Nahm et al, 2010). In this study carer burden may be an issue as family/carers move towards a more active/supportive role as a result of the hip fracture.…”

“…Frequently the unexpected role and the number of activities that occurred felt overwhelming. Stress, anxiety, frustration, sadness, confusion and lack of time to balance the new role with their personal-life were common feelings identified by carers (Giosa et al, 2014;Nahm et al, 2010;Toscan et al, 2011). Moreover, carers often described the hospital setting and procedures as uninviting and expressed their discontent with the lack of information they received (Giosa et al, 2014).…”

“…Stress, anxiety, frustration, sadness, confusion and lack of time to balance the new role with their personal-life were common feelings identified by carers (Giosa et al, 2014;Nahm et al, 2010;Toscan et al, 2011). Moreover, carers often described the hospital setting and procedures as uninviting and expressed their discontent with the lack of information they received (Giosa et al, 2014). Furthermore, it is well known that the physical, psychosocial and economic impact of caring for family members is higher in women who, due to their gendered roles, continue bearing the overwhelming responsibility for home and long term provision of care services (Navaie-Valiser, 2002;Paoletti, 2002;Pinquart & Sorensen, 2006;Twigg et al, 2011).…”

“…Furthermore, it is well known that the physical, psychosocial and economic impact of caring for family members is higher in women who, due to their gendered roles, continue bearing the overwhelming responsibility for home and long term provision of care services (Navaie-Valiser, 2002;Paoletti, 2002;Pinquart & Sorensen, 2006;Twigg et al, 2011). Some studies identified that carer's burden and needs change during different phases of recovery (Giosa et al, 2014). The burden was greatest after surgery and decreased over time with a satisfactory recovery and when carers had a better knowledge about their own role (Giosa et al, 2014;Nahm et al, 2010).…”