Informal carer support needs, facilitators and barriers in transitional care for older adults from hospital to home: A scoping review

Abstract

AimTo synthesise evidence about informal carers' (carers) experience of their support needs, facilitators and barriers regarding transitional care of older adults with multimorbidity.BackgroundCarers provide crucial support for older adults during care transitions. Although health practitioners are well positioned to support carers, system factors including limited healthcare resources can compromise the quality of care transitions.DesignScoping review.MethodsSearches were undertaken of the published literature. Five databases were searched including MEDLINE, CINAHL, EMBASE, PsycINFO and the Cochrane Library. Two reviewers independently screened articles to identify relevant studies. Studies were retrieved from January 2000 to July 2022. Data were extracted and tabulated for study characteristics, support needs, facilitators and barriers. Key themes and patterns were synthesised across the studies.ResultsEighteen studies including N = 3174 participants were retrieved. Most studies (n = 13) employed qualitative designs. Five studies used surveys. Carers reported their need to: be involved in coordinated discharge planning; advocate and be involved in decision‐making; and receive community‐based follow‐up. Carers described facilitators and barriers in four themes: (1) relationships with the older adult and health practitioners, (2) being involved in coordinated discharge planning; (3) communication and information strategies; and (4) community‐based follow‐up. Synthesis of themes across all studies resulted in the identification of five areas of research: carers' health literacy; community‐based care; carers' involvement in transitional care planning; inpatient and community health practitioners' communication skills; and culturally diverse carers' experiences.Conclusion and Relevance to Clinical PracticeThe review highlights the importance of quality communication and relationships between carers, older adults, health practitioners and health organisations. Although information and education are important there is a need for further research to examine systems that support communication between carers, older adults and health practitioners and health literacy for all carers including culturally diverse carers.

‘Hearing silences’: Exploring culturally safe transitional care: A qualitative study among Turkish‐speaking migrant frail older adults

“…It was also shown in our study that the support of informal caregivers, such as spouses, family, friends and neighbours, who provide unpaid support to an older adult during a care transition period (Allen et al, 2023), is one of the main facilitators of transitional care (Joo & Liu, 2023).…”

“…Although getting verbal and written information from health care staff and being involved in treatment decisions was important during hospitalization and the early period of discharge, taking support from the community gained importance during the later transition period. Taking part in informed decision-making, which is required to educate and train caregivers about older patients' medical conditions, symptom management, management of cognitive difficulties and access to community-based services, ensures that older people' care needs are met (Allen et al, 2023;Kraun et al, 2022). Older patients often experienced limited communication with healthcare staff, which is closely related to high rates of readmission (Dolu et al, 2023).…”

“…Older patients often experienced limited communication with healthcare staff, which is closely related to high rates of readmission (Dolu et al, 2023). Although it is already known that older ethnic minority patients tend to experience poor communication with healthcare staff due to their limited language proficiency (Dolu et al, 2023), there is still a lack of information available in relevant languages for ethnically and linguistically diverse population (Allen et al, 2023).…”