Factors Affecting the Outcomes of Hospitalized Dementia Patients: From Home to Hospital to Discharge

Abstract

This study examined factors associated with willingness to continue in the caregiving role after the hospitalization of a relative with dementia. Interviews were conducted with 179 caregivers of hospitalized patients to determine the influences of predisposing, enabling, and need factors in the discharge decision. Logistic regression was used to identify variables predictive of caregivers taking patients home for those who were originally planning on doing so and for those who were originally undecided. For the first group, only a prolonged hospital stay significantly influenced the discharge disposition. The undecided caregivers were likely to seek placement for patients with more severe cognitive impairment, although having formal assistance with specific tasks increased the probability of a discharge home.

A review of family carers' experiences of hospital discharge for people with dementia, and the rationale for involving service users in health research

“…A family carer played a key role in the transition back home, and an early study by Cox and Verdieck 45 found that if there were formal services in place and the carer had assistance with medication, bathing and supervision, and support and counseling, then the patient tended to return home from hospital rather than making the transition to a care home. However, carers needed to know how to negotiate service provision and manage the care of the patient in conjunction with services, 25 particularly with regard to timing and levels of service provision that may fail to meet the families’ requirements.…”

“…37 The literature found that hospital discharge planning is very important to many carers 54 and that carers are seen as playing a key role in the patients’ discharge. 45 However, carers reported a lack of communication with health professionals, not being listened to and feeling undervalued as a resource. 53 A lack of communication and professional support may explain the reasons why some carers may not comply with hospital instructions, care plans, or appointments or refuse any help offered.…”

“…Of the ten studies, four (five papers) were from the USA, 17 , 25 , 45 – 47 three from the UK, 48 – 50 two (four papers) from Australia, 51 – 54 and one from Taiwan. 55 Three studies used a cross-sectional telephone survey, 17 , 45 , 47 three studies conducted qualitative interviews with carers, 49 , 51 – 53 , 55 and three studies utilized a mixed methods approach. 25 , 48 , 54 One study performed a secondary statistical analysis from a parent study.…”

Service needs and use: A further look at the experiences of African American and white caregivers seeking Alzheimer's assistance

“…Several studies have indicated that caregiver needs, as determined by stress and burden, are critical factors in the decision to use services. [13][14][15] …”

Racial Differences in Hospital Discharge Disposition among Stroke Patients in Maryland

“…Studies in stroke and dementia have shown that insurance type is a predictor of discharge disposition. 27,28 If insurance type predicts discharge disposi-tion, insurance status (whether or not the patient is insured) may also predict discharge disposition.…”