alexa
Reach Us +44-1647-403003
Transitional Care for Older Adults: The Need for New Approaches to Support Family Caregivers | OMICS International
ISSN: 2167-7182
Journal of Gerontology & Geriatric Research
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Transitional Care for Older Adults: The Need for New Approaches to Support Family Caregivers

Constance R. Uphold*
Department of Aging & Geriatrics, College of Medicine, University of Florida, USA
Corresponding Author : Constance R. Uphold
Associate Director of Implementation and Outcomes Research
Geriatrics Research Education and Clinical Center
University of Florida, USA
Tel: 352-376 1611
Fax: 352-271- 4541
E-mail: [email protected]
Received March 23, 2012; Accepted March 23, 2012; Published March 30, 2012
Citation: Uphold CR (2012) Transitional Care for Older Adults: The Need for New Approaches to Support Family Caregivers. J Gerontol Geriatric Res 1:e107. doi:10.4172/2167-7182.1000e107
Copyright: © 2012 Uphold CR. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Gerontology & Geriatric Research

Abstract

The importance of high quality transitional care in improving the outcomes of patients and families has gained increased attention. Transitional care is defined as actions designed to ensure coordination and continuity of care between levels of health care and across care settings. It is well known that when patients move between care settings untoward events often occur. For example, poor transitions in care can result in low patient satisfaction, serious medication errors, and increased use of emergency room services and unnecessary ambulatory care visits. In addition, lack of quality transitional care can result in high rates of rapid hospital readmissions -- the majority of which are potentially preventable. Older adults are particularly vulnerable to breakdown in continuity and coordination of care between settings, because they have multiple chronic diseases and complicated therapies.

 

The importance of high quality transitional care in improving the outcomes of patients and families has gained increased attention. Transitional care is defined as actions designed to ensure coordination and continuity of care between levels of health care and across care settings [1]. It is well known that when patients move between care settings untoward events often occur. For example, poor transitions in care can result in low patient satisfaction, serious medication errors, and increased use of emergency room services and unnecessary ambulatory care visits [2]. In addition, lack of quality transitional care can result in high rates of rapid hospital readmissions -- the majority of which are potentially preventable [3]. Older adults are particularly vulnerable to breakdown in continuity and coordination of care between settings, because they have multiple chronic diseases and complicated therapies [4].
Researchers have identified numerous barriers to effective care transitions, including inadequate discharge planning, poor communication between health care providers across the continuum of care, and limited access to and availability of needed services. However, one of the most overlooked and important gaps in transitional care is inadequate support and training of family caregivers. Consequently, national organizations have written recommendations and clinical practice guidelines that urge healthcare providers to respond not only to the needs of patients, but also to those of family caregivers. For example, the American Heart Association Scientific Statement [5] emphasizes that providers should focus on increasing family involvement in the following areas: 1) caregivers as members of interdisciplinary teams; 2) assessment and needs and concerns from the caregivers’ perspective; 3) importance of follow-up contacts and referral; 4) counseling focused on problem-solving and social support; 5) provision of information; and 5) attention to the emotional and physical health of caregivers.
Despite these recommendations, many informal caregivers continue to be dissatisfied with the information they receive and feel ill-prepared for caring for their loved ones as they move through the healthcare system [6]. Family caregivers play critical roles in supporting older adults during these transitions. However, only recently, has attention been paid to understanding caregivers’ needs and designing different strategies for improving caregivers’ abilities during various transitions in care [4].
It is known that there is great variation in the type and amount of information and support that caregivers need [7]. Researchers have found that individualized, tailored messages and support programs are more likely to improve caregivers’ knowledge, confidence, and abilities than generic programs [8]. In addition, comprehensive literature reviews recommend that interventions, such as building skills to solve problems, are more helpful than psychosocial education interventions [9]. Problem-solving interventions have been consistently found to improve outcomes of informal caregivers taking care of family members following surgery, ï»¿trauma, and chronic illnesses [10,11].The common components of these interventions are helping caregivers learn to manage negative emotional responses, to view caregiving as a potentially rewarding experience, and to use a series of steps to solve problems [12,13].
Survivors of caregivers in intervention group had fewer emergency room visits and re-hospitalizations. Unfortunately many of these evidenced-based, problem-solving interventions have been underused in practice. The interventions typically require large amounts of staff time to implement and are often burdensome for family caregivers who have to travel for the intervention or be available for phone calls or visits to the home. On the other hand, the Internet may be a costeffective medium for improving caregivers’ knowledge and skills. As the National Institutes of Health [14] emphasize, the Internet is a promising technology for engaging family caregivers and ultimately for improving the quality of transitional care. Over 75% of Americans regularly use the Internet and adults 55 years of age and older are the most likely to seek information on the Web [15]. The advantage of the Internet is that caregivers can receive up-to-date information in a place and time that is convenient to them [16]. Further, the Internet optimizes the potential for healthcare providers to reach geographically isolated caregivers who are unable to leave the sides of their loved ones. An example of a web-based intervention is Pierce and colleagues [17] project, which used “Caring-Web”, a website designed to provide education and support to stroke caregivers in their homes. In this study, when the intervention group was compared with the control group, there were no differences in caregiver depression or well-being, but the stroke.
Similar to web-based training, online messaging between providers and patients and their caregivers has the potential to improve outcomes. As noted in a systematic review by Ye et al. [18] on-line messaging is a powerful clinical tool that is transforming the relationship between patients, families, and providers. Previous researchers found that online messaging improved quality of care [19] and reduced the cost of care [20]. Other benefits include patients’ and family members’ comfort while asking questions and the ability to save messages [21]. Only a few studies have explored on-line messaging between providers and caregivers. In a pilot project, Wade et al. [22] found that an online, interactive problem-solving intervention increased knowledge and improved problem-solving skills of caregivers of persons with traumatic brain injuries. Another study Rosen and Kwoh [23] found that family caregivers were satisfied and had positive attitudes about online messaging with providers.
In summary, improving the quality of transitional care that elders receive has the potential to limit adverse events and reduce avoidable hospital readmissions. Many factors contribute to the problems that older adults face when they move between care settings and levels. It is increasingly recognized that, one approach to improving transitional care is implementing interventions to support and train family members to be skilled and knowledgeable caregivers. In particular, it is known that interventions which involve building skills to solve problems are the most effective. The venue in which interventions are offered is also important. Technology-based approaches, such as web-based training and online messaging, are new venues to help caregivers get the right information and support at the right time and in the right place. These technologies have the potential to revolutionize the healthcare delivery system and provide new avenues for healthcare providers to interact with, teach, and support families in their critical roles as caregivers of older patients.
References
Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Article Usage

  • Total views: 11999
  • [From(publication date):
    May-2012 - Dec 16, 2018]
  • Breakdown by view type
  • HTML page views : 8208
  • PDF downloads : 3791
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2018-19
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri and Aquaculture Journals

Dr. Krish

[email protected]

+1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

streamtajm

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2018 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version