Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment
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. METH...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/trc2.12355 |
| _version_ | 1797948990116855808 |
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| author | Cameron J. Gettel Peter T. Serina Ivie Uzamere Kizzy Hernandez‐Bigos Arjun K. Venkatesh Andrew B. Cohen Joan K. Monin Shelli L. Feder Terri R. Fried Ula Hwang |
| author_facet | Cameron J. Gettel Peter T. Serina Ivie Uzamere Kizzy Hernandez‐Bigos Arjun K. Venkatesh Andrew B. Cohen Joan K. Monin Shelli L. Feder Terri R. Fried Ula Hwang |
| author_sort | Cameron J. Gettel |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-10T21:52:16Z |
| format | Article |
| id | doaj.art-7510f0ad3a8e48c28b5ebbba49e2d5c0 |
| institution | Directory Open Access Journal |
| issn | 2352-8737 |
| language | English |
| last_indexed | 2024-04-10T21:52:16Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| spelling | doaj.art-7510f0ad3a8e48c28b5ebbba49e2d5c02023-01-18T11:41:04ZengWileyAlzheimer’s & Dementia: Translational Research & Clinical Interventions2352-87372022-01-0181n/an/a10.1002/trc2.12355Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairmentCameron J. Gettel0Peter T. Serina1Ivie Uzamere2Kizzy Hernandez‐Bigos3Arjun K. Venkatesh4Andrew B. Cohen5Joan K. Monin6Shelli L. Feder7Terri R. Fried8Ula Hwang9Department of Emergency Medicine Yale School of Medicine New Haven Connecticut USADepartment of Emergency Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USADepartment of Emergency Medicine Yale School of Medicine New Haven Connecticut USASection of Geriatrics Department of Internal Medicine Yale School of Medicine New Haven Connecticut USADepartment of Emergency Medicine Yale School of Medicine New Haven Connecticut USASection of Geriatrics Department of Internal Medicine Yale School of Medicine New Haven Connecticut USASocial and Behavioral Sciences Yale School of Public Health New Haven Connecticut USAVA Connecticut Healthcare System West Haven Connecticut USASection of Geriatrics Department of Internal Medicine Yale School of Medicine New Haven Connecticut USADepartment of Emergency Medicine Yale School of Medicine New Haven Connecticut USAAbstract 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.https://doi.org/10.1002/trc2.12355barrierscare transitioncognitive impairmentemergency departmentqualitative |
| spellingShingle | Cameron J. Gettel Peter T. Serina Ivie Uzamere Kizzy Hernandez‐Bigos Arjun K. Venkatesh Andrew B. Cohen Joan K. Monin Shelli L. Feder Terri R. Fried Ula Hwang Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment Alzheimer’s & Dementia: Translational Research & Clinical Interventions barriers care transition cognitive impairment emergency department qualitative |
| title | Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment |
| title_full | Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment |
| title_fullStr | Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment |
| title_full_unstemmed | Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment |
| title_short | Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment |
| title_sort | emergency department care transition barriers a qualitative study of care partners of older adults with cognitive impairment |
| topic | barriers care transition cognitive impairment emergency department qualitative |
| url | https://doi.org/10.1002/trc2.12355 |
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