Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment
Year: 2022
Type: article
Abstract: INTRODUCTION: After emergency department (ED) discharge, persons living with cognitive impairment (PLWCI) and their care partners are particularly at risk for adverse outcomes. We sought to identify the barriers experienced by care partners of PLWCI during ED discharge care transitions. METHODS: We conducted a qualitative study of 25 care partners of PLWCI discharged from four EDs. We used the validated 4AT and care partner-completed AD8 screening tools, respectively, to exclude care partners of older adults with concern for delirium and include care partners of older adults with cognitive impairment. We conducted recorded, semi-structured interviews using a standardized guide, and two team members coded and analyzed all professional transcriptions to identify emerging themes and representative quotations. RESULTS: Care partners' mean age was 56.7 years, 80% were female, and 24% identified as African American. We identified four major barriers regarding ED discharge care transitions among care partners of PLWCI: (1) unique care considerations while in the ED setting impact the perceived success of the care transition, (2) poor communication and lack of care partner engagement was a commonplace during the ED discharge process, (3) care partners experienced challenges and additional responsibilities when aiding during acute illness and recovery phases, and (4) navigating the health care system after an ED encounter was perceived as difficult by care partners. DISCUSSION: Our findings demonstrate critical barriers faced during ED discharge care transitions among care partners of PLWCI. Findings from this work may inform the development of novel care partner-reported outcome measures as well as ED discharge care transition interventions targeting care partners.
DOI: 10.1002/trc2.12355
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,200
Funders: John A. Hartford Foundation, Alzheimer's Association, Hartford Foundation for Public Giving, Yale University, National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Center for Advancing Translational Sciences, Yale Center for Clinical Investigation, Yale School of Medicine
Awards: Attachment Behaviors in Parent Child Dyads Coping with Early Stage Alzheimer's Disease and Related Dementias, Dementia and Decision-Making for Older Adults without Surrogates, Assessment of a Novel Emergency Care Equity-Based Caregiver Outcome Measure, Yale Scholars in Implementation Science (YSIS), Development and validation of the Patient-Reported Outcome Measure - Older adult care Transitions from the Emergency Department (PROM-OTED) tool, G6881567127, Geriatric Emergency care Applied Research network 2.0 - Advancing Dementia Care (GEAR 2.0 ADC), Yale University Clinical and Translational Science Award Program, NIA AD/ADRD Health Care Systems Research Collaboratory, Growing the Geriatric Emergency care Applied Research (GEAR 1.1) network: Expanding and sustaining an emergency care aging study infrastructure., Claude D. Pepper Older Americans Independence Center at Yale
OpenAlex ID: W4303513191