Improving care transitions of older people: Challenges for today and tomorrow

Cheek, Julianne; Ballantyne, Alison; Gillham, David; Mussared, Jane; Flett, Penny; Lewin, Gill; Walker, Marita; Roder‐Allen, Gerda; Quan, James; Vandermeulen, Suzanne

doi:10.1108/14717794200600024

Cited by 21 publications

(20 citation statements)

References 17 publications

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“…Manageable transitions exhibit features consistent with the goals of the GEM model of care (Ellis et al, 2011) and components of successful care transition interventions (Sahota et al, 2016). Numerous studies have reported the importance of active engagement of patients and the need to make adjustments to care plans based on patient experience (Coleman et al, 2004;Walker et al, 2015;Allen et al, 2016;Cheek et al, 2006) As reported elsewhere (Allen et al, 2016;Baillie et al, 2014;Giosa et al, 2014;Byrne et al, 2011) carers in this study had a critical role in optimising care transitions by seeking out information, negotiating with providers and promoting self-management. As reliance on carers can lead to them feeling overwhelmed by their role (Toscan et al, 2012) the expectations imposed by services and the work of carers in care transitions warrant further exploration.…”

Section: Discussionsupporting

confidence: 62%

Care transition types across acute, sub-acute and primary care

Harvey

Foster

Quigley

et al. 2018

JICA

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Purpose-The purpose of the paper is to examine the care transitions of older people who transfer between home, acute and sub-acute care to determine if there were common transition types and areas for improvements. Design/methodology/approach-A longitudinal case study design was used to examine care transitions of 19 older people and their carers as a series of transitions and a whole-of-system experience. Case study accounts synthesising semi-structured interviews with function and service use data from medical records were compared. Findings-Three types of care transitions were derived from the analysis: manageable, unstable and disrupted. Each type had distinguishing characteristics and older people could experience elements of all types across the system. Transition types varied according to personal and systemic factors. Originality/value-This study identifies types of care transition experiences across acute, sub-acute and primary care from the perspective of older people and their carers. Understanding transition types and their features can assist health professionals to better target strategies within and across the system and improve patient experiences as a whole.

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Section: Discussionsupporting

confidence: 62%

Care transition types across acute, sub-acute and primary care

Harvey

Foster

Quigley

et al. 2018

JICA

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“…A central and recurring theme identified in this study is the difficulty experienced by carers in accessing and making sense of the information they were provided with about services ; a concern also acknowledged in the literature (Cheek et al 2006). In the case of respite services, the literature acknowledges the problem with carers' lack of awareness of the existence of respite and lack of knowledge about how to obtain it (Hanson, Tetley and Clarke 1999;Ritchie 2003 ;Witt, Chenoweth and Jeon 2004).…”

Section: Discussionmentioning

confidence: 82%

Seeking respite: issues around the use of day respite care for the carers of people with dementia

et al. 2011

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Ageing in Place policies have transferred responsibility for many frail elderly people and those living with dementia from residential to in-home care. Despite this placing a greater obligation on families, in Australia carers continue to under-use day respite services. This qualitative design study identified issues around the use of day respite care from the perspective of the family carer, focusing on barriers to attendance and strategies to facilitate attendance. Telephone interviews were held in 2007 with Tasmanian carers whose family member refused to attend day respite care (ten carers) and those whose family member attended (17). Carers considering day respite care were often overwhelmed by the quantity of information, confused about the process, and worried about the recipient's safety in an unfamiliar environment. They felt anxious about public acknowledgement of the condition leading to fear of embarrassment. Day respite care users appreciated the break it provided them and the opportunity for their family member to socialise. To facilitate a greater uptake of day respite care, reliable information sources and strategies to help carers deal with the emotions they face on a daily basis, together with a wider social acceptance of dementia, are important. Furthermore, carers need an opportunity to talk with others, enabling them to gain support from those who have successfully introduced a family member to day respite care.

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“…The impact of socio-economic factors on the likelihood of transition to nursing home care has also been examined, both in isolation and in conjunction with health conditions (Grundy and Jitlal 2007; Martikainen, Nihtilä and Moustgaard 2008; Miller and Weissert 2000). More broadly, the importance of care transitions by older people into community care as well as nursing homes is increasingly being recognised (Cheek et al 2006; Martikainen, Nihtilä and Moustgaard 2008; Mehdizadeh 2002).…”

Section: Introductionmentioning

confidence: 99%

Care trajectories through community and residential aged care services: disease effects

et al. 2012

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As in other ageing populations, dementia, musculoskeletal conditions and cardiovascular disease affect a high proportion of Australians aged over 65 years, and the prevalence of these conditions increases significantly with age. People with these conditions may need to access a range of care services over time to enable them to remain living in their homes. Many eventually need to move into a nursing home.In contrast to the considerable recent literature on the funding of long-term care systems for population ageing, studies on the care pathways followed by individuals are much less common. This paper explores the effect of disease on use of community care services and nursing homes over time, focusing on people with dementia, cardiovascular disease and musculoskeletal conditions. Care-use transitions are identified using linked administrative client data for a cohort of 33,300 community-living Australians who had an aged care assessment in 2003-04 and who had not previously used aged care services.The different symptoms and courses of diseases meant that the patterns of aged care service use, both in terms of care services accessed and the timing of this access, varied considerably for people with different health conditions. These differences persisted across a range of client characteristics. In particular, people with dementia or cerebrovascular disease as their main health condition were more likely to enter nursing home care than those with heart disease or musculoskeletal conditions.The variation in use of aged care services according to disease group need to be taken into account in any projections of demand for aged care. Such projections must allow for predictions of disease prevalence, or else they will yield inaccurate predictions of demand for both community and residential care.

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Improving care transitions of older people: Challenges for today and tomorrow

Cited by 21 publications

References 17 publications

Care transition types across acute, sub-acute and primary care

Care transition types across acute, sub-acute and primary care

Seeking respite: issues around the use of day respite care for the carers of people with dementia

Care trajectories through community and residential aged care services: disease effects

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