Hospital to Home: Supporting the Transition From Hospital to Home for Older Adults.
Brittany Barber, Lori Weeks, Lexie Steeves-Dorey and 4 others
PMID 34704507WHAT IT FOUND
Family caregivers of three older adults stuck in hospital learned about enhanced home care only after burnout or decline.
Overnight and inconsistent support, plus prior negative experiences, made returning home feel impossible.
Key findings
01Caregivers did not know what enhanced home care could add until after hospital admission or rapid decline.
02Caregiver burnout and negative or inadequate home care experiences made families unwilling to discuss returning home.
03Absent overnight support and inconsistent home care workers contributed to a caregiver feeling she had no choice but to seek long-term care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only three cases were completed, and COVID-19 stopped recruitment of a fourth. The study was in one acute care unit in Nova Scotia, so experiences may not transfer to other hospitals or communities. Only one focal patient was interviewed because two had cognitive decline, so most patient perspectives came from caregivers and professionals. No comparison group or outcome measures were used, so it cannot show whether enhanced home care would have prevented long-term care admission. Patient selection depended on a professional identifying someone who might still return home.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Nova Scotia Health Research Foundation under grant number 1590.
The easy way to misread this
Do not conclude that enhanced home care would have kept these older adults home or reduced long-term care admissions. There was no comparison group and only three cases, so the paper describes barriers and caregiver experiences, not treatment effects.