‘Out of Hospital’: a scoping study of services for carers of people being discharged from hospital

Abstract

Successive government policies have highlighted the need to inform and involve carers fully in the hospital discharge process. However, some research suggests that many carers feel insufficiently involved and unsupported in this process. This paper summarises a scoping review to identify what the UK literature tells us about the service provision for carers, and its effectiveness, around the time of hospital discharge of the care recipient, and also describes a mapping exercise of the work currently being done by Princess Royal Trust for Carers Centres in England to support carers around the time of hospital discharge. The restriction to UK literature was dictated by the nature of the project; a modest review carried out for a UK-based voluntary sector organization. Fifty-three documents were reviewed, of which 19 papers (representing 17 studies) were reporting on primary research. As only five of these studies actually involved an intervention, it appears there is very little research from the UK which evaluates specific interventions to support carers around the time of hospital discharge of the care recipient. While the mapping exercise showed that in some areas there are services and/or initiatives in place which have been designed to improve the process of discharge for carers, in many places there is still a gap between what policy and research suggest should happen and what actually happens to carers at this time. Even where services and initiatives to support carers through the discharge process exist, there is only limited evidence from research or evaluation to demonstrate their impact on the carer's experience. Further research, both quantitative and qualitative, is required to address these areas and enable commissioners, providers and carers' organizations to work together towards a service in which patients and carers alike receive the support and help they need at this significant time of transition.

A qualitative exploration of how Canadian informal caregivers in medical tourism use experiential resources to cope with providing transnational care

“…Previous research has shown that care transitions – such as between the home and hospital – can be a time where poor management occurs and there is an increased risk of medical complications (Borthwick et al . , Brock et al . , Cadogan et al .…”

Experiences of Older Adults in Transition from Hospital to Community

“…Gaps in the provision of post-discharge care have been known to present a problem for health care delivery for some time, not only in Canada but elsewhere as well (Arbaje et al, 2008 ;Borthwick et al, 2009 ;Boughton & Halliday, 2009 ). The lack of effective transitional care after hospitalization has been linked to readmissions, especially among those with lower socioeconomic status and lack of social support (Arbaje et al, 2008 ).…”

“…Shortened hospital stays have become a hallmark of many health care systems. In this context, the lack of continuity of care during the transition from hospital to community has been identified as a problem with serious negative implications for the well-being of individuals in many countries where this has been studied, including Canada, the United States, the United Kingdom, Australia, Sweden, and Japan (Borthwick, Newbronner, & Stuttard, 2009 ;Boughton & Halliday, 2009 ;Efraimsson, Sandman, Hydén, & Rasmussen, 2006 ;Naylor, 2012 ;Tomura, Yamamoto-Mitani, Nagata, Murashima, & Suzuki, 2011 ).…”

Who cares for the carers at hospital discharge at the end of life? A qualitative study of current practice in discharge planning and the potential value of using The Carer Support Needs Assessment Tool (CSNAT) Approach

“…There has been a lack of research into interventions to support carers at hospital discharge in general: a scoping review of service provision for carers around hospital discharge found only five studies involved an intervention, none of which focussed on the discharge process as directly related to carers. 22 A systematic review of randomised controlled trials (RCTs) of discharge planning interventions found only 14 separate studies conducted over a 19-year period. 26 The review concluded that integration of caregivers into discharge planning reduces risk of hospital readmission, but was unable to determine the most effective method of caregiver integration.…”