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An Examination of Family Caregiver Experiences during Care Transitions of Older Adults*

Published online by Cambridge University Press:  23 April 2014

Justine L. Giosa
Affiliation:
School of Public Health and Health Systems, University of Waterloo, Ontario
Paul Stolee*
Affiliation:
School of Public Health and Health Systems, University of Waterloo, Ontario
Sherry L. Dupuis
Affiliation:
Department of Recreation and Leisure Studies, University of Waterloo, Ontario
Steven E. Mock
Affiliation:
School of Public Health and Health Systems, University of Waterloo, Ontario Department of Recreation and Leisure Studies, University of Waterloo, Ontario
Selena M. Santi
Affiliation:
School of Public Health and Health Systems, University of Waterloo, Ontario
*
La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Paul Stolee, Ph.D. School of Public Health and Health Systems University of Waterloo 200 University Avenue West Waterloo, ON N2L 3G1 (stolee@uwaterloo.ca)

Abstract

This study explored informal family caregiver experiences in supporting care transitions between hospital and home for medically complex older adults. Using a qualitative, grounded-theory approach, in-depth semi-structured interviews were conducted with community and resource case managers, as well as with informal caregivers of older hip-fracture and stroke patients, and of those recovering from hip replacement surgery. Six properties characterizing caregiver needs in successfully transitioning care between hospital and home were integrated into a theory addressing both a transitional care timeline and the emotional journey. The six properties were (1) assessment of unique family situation; (2) practical information, education, and training; (3) involvement in planning process; (4) agreement between formal and informal caregivers; (5) time to make arrangements in personal life; and (6) emotional readiness. This work will support research and clinical efforts to develop more well-informed and relevant interventions to most appropriately support patients and families during transitional care.

Résumé

Cette étude a examiné les expériences informelles des aidants familiaux en soutenant les transitions de soins entre l’hôpital et la maison pour les adultes âgés avec des conditions médicales complexes. En utilisant une approche basée sur la théorie ancrée qualitative, une série d’entretiens semi-structurés a été realisée avec la communauté et des gestionnaires de cas et de ressources, ainsi qu’avec des aidants naturels de patients âgés souffrant de fractures de la hanche et des accidents vasculaires cérébraux et ceux qui se remettaient d’une chirurgie pour remplacement de la hanche. Six propriétés qui caractérisent les besoins des aidants naturels de fournir des soins de transition entre l’hôpital et la maison avec succès ont été intégrées dans une théorie qui adressent (1) l’horaire des soins transitoires et (2) le passage émotionnel. Ces six propriétés comprennent : (1) l’évaluation des situations familiales; (2) des informations sur les pratiques; (3) l’éducation et la formation; (4) l’accord entre les aidants officiels et informels; (5) le temps de prendre des dispositions pour la vie personnelle, et (6) la préparation affective et émotionelle. Cette étude soutiendra le développement d’interventions mieux informées et plus pertinentes, qui offrent le soutien le plus approprié pour les patients et leurs familles pendant les soins de transition.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2014 

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Footnotes

*

This study was funded by an Emerging Team grant from the Canadian Institutes of Health Research. Justine Giosa was also supported by the Canadian Institutes of Health Research (Sir Frederick Banting and Charles Best Canada Graduate Scholarship Master’s Award). We are grateful to the family caregivers and health care providers who participated in this study, to Heather Drouin for assisting with the formatting and referencing of the manuscript, and to the members of the InfoRehab research team for their support and advice.

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