The experience of daily life of acutely admitted frail elderly patients one week after discharge from the hospital

Abstract

IntroductionFrail elderly are at higher risk of negative outcomes such as disability, low quality of life, and hospital admissions. Furthermore, a peak in readmission of acutely admitted elderly patients is seen shortly after discharge. An investigation into the daily life experiences of the frail elderly shortly after discharge seems important to address these issues. The aim of this study was to explore how frail elderly patients experience daily life 1 week after discharge from an acute admission.MethodsThe qualitative methodological approach was interpretive description. Data were gathered using individual interviews. The participants were frail elderly patients over 65 years of age, who were interviewed at their home 1 week after discharge from an acute admission to a medical ward.ResultsFour main categories were identified: “The system,” “Keeping a social life,” “Being in everyday life,” and “Handling everyday life.” These categories affected the way the frail elderly experienced daily life and these elements resulted in a general feeling of well-being or non-well-being. The transition to home was experienced as unsafe and troublesome especially for the more frail participants, whereas the less frail experienced this less.Conclusion and discussionSeveral elements and stressors were affecting the well-being of the participants in daily life 1 week after discharge. In particular, contact with the health care system created frustrations and worries, but also physical disability, loneliness, and inactivity were issues of concern. These elements should be addressed by health professionals in relation to the transition phase. Future interventions should incorporate a multidimensional and bio-psycho-social perspective when acutely admitted frail elderly are discharged. Stakeholders should evaluate present practice to seek to improve care across health care sectors.

How older people enact care involvement during transition from hospital to home: A systematic review and model

“…This was demonstrated through showing disappointment when expectations about care were not met . Resigned non‐involvement was reported alongside highly influential contextual factors such as low mood and ill‐health and was arguably the most debilitating subtype of non‐involvement . The second type of involvement, information‐acting, could be active or passive.…”

“… This resulted in patients and caregivers moving between states of involvement in attempting to resolve a single aspect of care. Challenging and chasing, as the third type of involvement, highlighted the work and effort required to question staff and source information . Examples of chasing were seen exclusively in caregivers.…”

“…Three thousand and sixty publications were identified, which through screening ( Figure 1) provided sixteen studies that contributed to the development of the model. [20][21][22][28][29][30][31][32][33][34][35][36][37][38][39][40] The studies collectively included 303 participants with 170 patients in 12 studies and 133 caregivers in eleven (see Table 1). One study specifically sought to include patients from ethnic minority backgrounds including gypsy travellers 30 ; other studies did not specify the make-up of their study population.…”

“ Who'll do all these if I'm not around?” : Bonding social capital and health and well-being of inpatients

“…A study among recurrent inpatients showed that construction of strong social ties was crucial to reducing hospitalization (Andreasen, Lund, Aadahl, & Sørensen, 2015). In many sub-Saharan African countries, the influence of relatives and sometimes neighbours, on access to and use of health services work, partly because of “reverse responsibility”.…”

“…However, while being sick ensures increased care and support from close social ties, such conditions are also known to lead to social network attrition through the loss of critical support that is not offered as part of clinical treatments (Halpern, 2005; Lewis, DiGiacomo, Currow, & Davidson, 2014). For instance, a study among frequently hospitalized persons in Denmark’s health sector observed that chronic illness reduces contact with close social ties and subsequently weaken said relationships (Andreasen et al, 2015). Furthermore, like other forms of social capital, the effectiveness of BSC is predicated on cognitive social capital elements such as trust, norms, identities and harmony.…”