Over a three-month period in late 2018, we fielded an online survey to clinicians ranging from nurses, to occupational therapist to discharge coordinators. In all, over 60 clinicians answered our questions as we worked to understand how clinicians perceived family caregiver engagement in the discharge or transition of elderly patients. We wanted to strengthen our understanding of how we can improve the transition process, especially through training, education and direct support.
In our survey, 95% of discharge and transition teams agree that confident and competent family members can positively influence outcomes for a patient. However, clinicians believed that close to four out of every ten families refuse or delay a discharge because they feel unprepared or unable to cope with providing care at home. And this directly impacts the healthcare system: longer discharges translate into longer hospital stays, generating unnecessary hospital bed occupancy. As one of the clinicians participating in our survey illustrated: “When family caregivers are not prepared, they are uncomfortable taking the patient back home even though the patient has met all goals set in rehab. This results in longer, unnecessary stay in the facility”.
Moreover, the vast majority of clinicians (88%) frequently see family members stressed or burned out, which has implications for clinicians involved in discharge planning. An amazing 64% of clinicians were contacted by family caregivers following discharge. This clearly indicates that once families were home, they needed somewhere to go; the need for resources was still there and didn’t end at discharge. As one clinician confirmed: “When family caregivers are unable to get in touch with a doctor about a problem, they end up in the ER”, while another mentioned that “Often times we find patients end up back in the hospital if not educated appropriately.” This creates additional stress to hospital resources when these caregivers could have easily been accommodated outside the clinic.
Most clinicians in our survey said that preparation level is a big influencer on discharge plans – 66% indicate that family caregivers are important to transitions. But only about 20% of our survey respondents specifically referenced education as a way to support families – although many vaguely mentioned “support” or “community programs”. This may be because there are very limited resources available to clinicians to educate families at the point of discharge. There is a significant mismatch between what clinicians feel families need, and what they are able to provide them at discharge.
To read the full white paper, visit our Evidence Base page here.