Unique Care Needs of People with Dementia and Their Caregivers during Transitions from Skilled Nursing Facilities to Home and Assisted Living: A Qualitative Study |
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| Affiliation: | 1. University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, NC, USA;2. Duke University, School of Medicine, Durham, NC, USA;3. University of North Carolina at Chapel Hill, Gillings School of Public Health, Chapel Hill, NC, USA;4. Yale University, School of Public Health, New Haven, CT, USA;5. University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA;1. Department of Social Work, University of Maryland Baltimore County, Baltimore, MD, USA;2. Helen Bader School of Social Welfare, University of Wisconsin Milwaukee, Milwaukee, WI, USA;3. Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;1. Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada;2. Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;3. Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada;1. Department of Geriatrics, CHU Amiens-Picardie, Amiens, France;2. University Lille, CHU Lille, ULR 2694–METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France;3. Department of Geriatrics, CHU Lille, Lille, France;4. University Lille, CHU Lille, Palliative Care Unit, F-59000, Lille, France;5. ETHICS (Experiment, Transhumanism, Human Interactions, Care and Society), Lille Catholic University, Lille, France;6. Department of Geriatrics, Lille Catholic Hospitals, Lille, France |
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| Abstract: | ObjectivesThe purpose of the study was to describe unique care needs of people with dementia (PWD) and their caregivers during transitions from skilled nursing facilities (SNF) to home.DesignA qualitative study using focus groups, semistructured interviews, and descriptive qualitative analysis.Setting and ParticipantsThe study was set in one state, in 4 SNFs where staff had experience using a standardized transitional care protocol. The sample included 22 SNF staff, 4 home health nurses, 10 older adults with dementia, and their 10 family caregivers of whom 39 participated in focus groups and/or interviews.MethodsData collection included 4 focus groups with SNF staff and semistructured interviews with home health nurses, SNF staff, PWD, and their family caregivers. Standardized focus group and interview guides were used to elicit participant perceptions of transitional care. We used the framework analytic approach to qualitative analysis. A steering committee participated in interpretation of findings.ResultsParticipants described 4 unique care needs: (1) PWD and caregivers may not be ready to fully engage in dementia care planning while in the SNF, (2) caregivers are not prepared to manage dementia symptoms at home, (3) SNF staff have difficulty connecting PWD and caregivers to community supports, and (4) caregivers receive little support to address their own needs.Conclusions and ImplicationsBased on findings, recommendations are offered for adapting transitional care to address the needs of PWD and their caregivers. Further research is needed (1) to confirm these findings in larger, more diverse samples and (2) to adapt and test interventions to support successful community discharge of PWD and their caregivers. |
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| Keywords: | Dementia caregivers transitional care skilled nursing facilities qualitative research |
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