The effect of volunteers’ care and support on the health outcomes of older adults in acute care: A systematic scoping review

Abstract

Aim To examine the available evidence on the effects of care and support provided by volunteers on the health outcomes of older adults in acute care services. Background Acute hospital inpatient populations are becoming older, and this presents the potential for poorer health outcomes. Factors such as chronic health conditions, polypharmacy and cognitive and functional decline are associated with increased risk of health care‐related harm, such as falls, delirium and poor nutrition. To minimise the risk of health care‐related harm, volunteer programmes to support patient care have been established in many hospitals worldwide. Design A systematic scoping review. Methods The review followed the PRISMA Extension for Scoping Reviews (PRISMA‐ScR) (File S1). Nine databases were searched (CINAHL, MEDLINE, EMBASE, Cochrane, Scopus, Web of Science, PubMed, ScienceDirect and JBI) using the following key terms: ‘hospital’, ‘volunteer’, ‘sitter’, ‘acute care’, ‘older adults’, ‘confusion’, ‘dementia’ and ‘frail’. The search was limited to papers written in English and published from 2002–2017. Inclusion criteria were studies involving the use of hospital volunteers in the care or support of older adult patients aged ≥ 65 years, or ≥ 50 years for Indigenous peoples, with chronic health conditions, cognitive impairment and/or physical decline or frailty, within the acute inpatient settings. Results Of the 199 articles identified, 17 articles that met the inclusion criteria were critically appraised for quality, and 12 articles were included in the final review. Conclusions There is evidence that the provision of volunteer care and support with eating and drinking, mobilising and therapeutic activities can impact positively upon patient health outcomes related to nutrition, falls and delirium. Further robust research is needed to determine the impact of volunteers in acute care and the specific care activities that can contribute to the best outcomes for older adults. Relevance to clinical practice Volunteers can play a valuable role in supporting care delivery by nurses and other health professionals in acute care services, and their contribution can improve health outcomes for older adults in this setting.

Norwegian Nurses’ Reflections Upon Experiences of Ethical Challenges in Older People Care: A Qualitative Thematic Analysis

“…An intensified workload without the necessary increase of resources, personnel or time, may lead to nurses being forced to decide what care to give, and what care to leave out (Suhonen et al, 2018). The authors support the idea that volunteers should be integrated into the care of older people, and volunteer programs are found to improve patients' health and well-being (Blais et al, 2017;Saunders et al, 2019). Nevertheless, there is a need for more qualified staff, and especially young nurses in this study wished for collegial supervision from more experienced health professionals when encountering challenging situations.…”

Navigating cancer treatment and care when living with comorbid dementia: an ethnographic study

“…Our study has offered significant new insights into the challenges people with dementia and their family members and staff supporting them face when navigating attendance at a hospital for cancer treatment and care. There has been extensive progress in improving the care of people with dementia admitted to acute hospitals [ 17 ] including consideration of how care is delivered [ 18 – 20 ], staff training on dementia [ 21 , 22 ] and the suitability of the physical environment [ 23 ]. However, to date, this has focussed predominantly on in-patient settings [ 24 ] and thus has largely not included out-patient areas including oncology departments.…”

“…There has been extensive progress in improving the care of people with dementia admitted to acute hospitals [17] including consideration of how care is delivered [18][19][20], staff training on dementia [21,22] and the suitability of the physical environment [23]. However, to date, this has focussed predominantly on in-patient settings [24] and thus has largely not included outpatient areas including oncology departments.…”

Nutrition and Delirium

“…Making opportunities for shared dining experiences and inviting family presence at mealtimes can help to normalise the mealtime experience and may improve intake [40,41]. Volunteers and healthcare assistants may also have a role in mealtime assistance and improving the mealtime experience [42][43][44].…”