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Medlin AR, Werner NE, Still CZ, Strayer AL, Fields BE. Factors associated with care partner identification and education among hospitalized persons living with dementia. PEC INNOVATION 2024; 5:100320. [PMID: 39101056 PMCID: PMC11296296 DOI: 10.1016/j.pecinn.2024.100320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 06/25/2024] [Accepted: 07/05/2024] [Indexed: 08/06/2024]
Abstract
Objective Care partners of persons living with dementia (PLWD) often feel unprepared to care for their loved ones. Improving PLWD care partner identification and education during hospital stays can improve preparedness. This retrospective EHR study investigated PLWD characteristics that may relate to care partner identification, education, and teaching methods during hospital stays. Methods Encounters from a Midwestern academic healthcare system were used. Patients were over 18, had a documented dementia diagnosis, were admitted to the hospital for at least 24 h, and had information documented in care partner or education data fields (N = 7982). Logistic regressions assessed patient's demographics, care partner identification and education. Chi-square tests compared education teaching methods and patient discharge location. Results PLWD's who were unmarried, discharged to other care facilities, or received the diagnosis "degeneration of nervous system due to alcohol" were associated with lacking care partner identification. Care partners of unmarried PLWDs or those with the diagnosis "Alzheimer's disease, unspecified" received less education. Multiple teaching methods were associated with discharge location. Conclusion Multiple characteristics were related to PLWD care partner identification and education differences during hospital stays. Innovation Novel analyses highlight need for a protocol to systematically prepare dementia care partners.
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Affiliation(s)
- Austin R. Medlin
- Department of Health & Wellness Design, Indiana University School of Public Health-Bloomington, Bloomington, USA
| | - Nicole E. Werner
- Department of Health & Wellness Design, Indiana University School of Public Health-Bloomington, Bloomington, USA
| | - Catherine Z. Still
- Department of Kinesiology, School of Education, University of Wisconsin-Madison, Madison, USA
| | | | - Beth E. Fields
- Department of Kinesiology, School of Education, University of Wisconsin-Madison, Madison, USA
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Nadash P. The State of Family Caregiving Policy. J Aging Soc Policy 2024; 36:479-489. [PMID: 38626336 DOI: 10.1080/08959420.2024.2339177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/05/2024] [Indexed: 04/18/2024]
Abstract
As the population ages and supportive services are increasingly delivered in home- and community-based settings, greater demands are placed on family caregivers. This essay introducing the special issue of the Journal of Aging and Social Policy discusses signs of progress on policies to ease the burden on family caregivers. It introduces a series of articles that reflect the growing body of research on caregiver-related policy actions. These actions range from expanding access to paid family leave and payment for providing care, to ensuring access to better data about family caregivers and improving the post- hospital discharge experiences of rural and underserved caregivers. It also explores a major conundrum around caregiving policy - why progress on family caregiving policy has been so slow, despite its clear importance to the health and welfare of those who receive supports, as well as to those providing supports. In addition, the essay discusses developments, such as Biden administration actions and the RAISE Family Caregiver Advisory Council, indicating that the political dynamic around caregiving has changed, concluding that this is a uniquely hopeful time for family caregiver-related policy.
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Affiliation(s)
- Pamela Nadash
- Department of Gerontology, Donna M and Robert J Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
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Griffin JM, Kaufman BG, Bangerter L, Holland DE, Vanderboom CE, Ingram C, Wild E, Dose AM, Stiles C, Thompson V. Improving Transitions in Care for Patients and Family Caregivers Living in Rural and Underserved Areas: The Caregiver Advise, Record, Enable (CARE) Act. J Aging Soc Policy 2024; 36:581-588. [PMID: 35156557 PMCID: PMC9374844 DOI: 10.1080/08959420.2022.2029272] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
In this Perspective, we contend bold action is needed to improve transitions from hospitals to home for aging patients and their family caregivers living in rural and underserved areas. The Caregiver Advise, Record, Enable (CARE) Act, passed in over 40 US states, is intended to provide family caregivers of hospitalized patients with the knowledge and skills needed for safe and efficient transitions. It has broken important ground for family caregivers who assist with transitions in patient care. It may fall short, however, in addressing the unique needs of family caregivers living in rural and underserved areas. We contend that to realize the intended safety, cost, and care quality benefits of the CARE Act, especially for those living in rural and underserved areas, states need to expand the Act's scope. We provide three recommendations: 1) modify hospital information systems to support the care provided by family caregivers; 2) require assessments of family caregivers that reflect the challenges of family caregiving in rural and underserved areas; and 3) identify local resources to improve discharge planning. We describe the rationale for each recommendation and the potential ways that an expanded CARE Act could reduce the risks associated with transitions in care for aging patients.
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Affiliation(s)
- Joan M. Griffin
- Division of Health Care Delivery Research (HCDR) and Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 1 Street SW, Rochester, MN 55905
| | | | | | - Diane E. Holland
- Health Services Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
| | - Catherine E. Vanderboom
- Health Services Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
| | | | | | - Ann Marie Dose
- Health Services Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
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Muntefering C, Kastrinos A, McAndrew NS, Ahrens M, Applebaum AJ, Bangerter L, Fields B. Integrating family caregivers in older adults' hospital stays: a needed cultural shift. Hosp Pract (1995) 2024:1-13. [PMID: 38767120 DOI: 10.1080/21548331.2024.2357510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/16/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVES This study aimed to examine perceived barriers and facilitators to caregiver inclusion in the hospital care of older adult family members or friends through the perspectives of (1) hospitalized older adults, (2) caregivers of a hospitalized older adult, (3) healthcare clinicians, and (4) policymakers. METHODS This qualitative descriptive exploratory study utilized semi-structured interviews with N = 24 participants and was analyzed using a framework method. RESULTS Eight codes arose that were categorized into four domains guided by the Social Ecological Model. Individual-level factors were determined both for the caregiver and for the clinician. Relationship-level factors were revealed pertaining to communication style and method. Hospital-level factors included hospital environment and resources. Societal-level factors included healthcare climate and policies. DISCUSSION Findings indicated that hospital workflows and policies inadequately support family caregivers. This study highlights potential solutions to caregivers' integration into hospital workflows.
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Affiliation(s)
- Chloe Muntefering
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Amanda Kastrinos
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Chennai, India
| | - Natalie S McAndrew
- School of Nursing, College of Health Professions & Sciences, University of Wisconsin- Milwaukee, Milwaukee, WI, USA
- Froedtert & the Medical College of Wisconsin, Froedtert Hospital, Patient Care Research, Milwaukee, WI, USA
| | - Madelyn Ahrens
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Allison J Applebaum
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Chennai, India
| | - Lauren Bangerter
- Health Economics Aging Research Institute, MedStar Health, Hyatssville, MD, USA
| | - Beth Fields
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
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Lee CR, Taggert E, Coe NB, Chatterjee P. Patient Experience at US Hospitals Following the Caregiver Advise, Record, Enable (CARE) Act. JAMA Netw Open 2023; 6:e2311253. [PMID: 37126344 PMCID: PMC10152302 DOI: 10.1001/jamanetworkopen.2023.11253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/19/2023] [Indexed: 05/02/2023] Open
Abstract
Importance Communication with caregivers is often not established or standardized during hospitalization. The Caregiver Advise, Record, Enable (CARE) Act is a state-level policy designed to facilitate communication among patients, caregivers, and clinical care teams during hospitalization to improve patient experience; 42 states have passed this policy since 2014, but whether it was associated with achieving these goals remains unknown. Objective To determine whether passage of the CARE Act was associated with improvements in patient experience. Design, Setting, and Participants This cohort study used a difference-in-differences analysis of short-term, acute-care US hospitals from 2013 to 2019 to analyze changes in patient experience before vs after CARE Act implementation in hospitals located in states that passed the CARE Act compared with those in states that did not. Analyses were performed between September 1, 2021, and July 31, 2022. Exposure Time-varying indicators for whether a hospital was in a state that passed the CARE Act. Main Outcomes and Measures Patient-reported experience via the Hospital Consumer Assessment of Healthcare Providers and Systems survey. Results A total of 2763 hospitals were included, with 2188 hospitals in CARE Act states and 575 in non-CARE Act states. There were differential improvements in patient experience in the measures of communication with nurses (unadjusted mean [SD] score, 78.40% [0.42%]; difference, 0.18 percentage points; 95% CI, 0.07-0.29 percentage points; P = .002), communication with physicians (mean [SD] score, 80.00% [0.19%]; difference, 0.17 percentage points; 95% CI, 0.06-0.28 percentage points; P = .002), and receipt of discharge information (mean [SD] score, 86.40% [0.22%]; difference, 0.11 percentage points; 95% CI, 0.02-0.21 percentage points; P = .02) among CARE Act states compared with non-CARE Act states after policy passage. In subgroup analyses, improvements were larger among hospitals with lower baseline Hospital Consumer Assessment of Healthcare Providers and Systems performance on measures of communication with nurses, communication with physicians, and overall hospital rating. Conclusions and Relevance These findings suggest that implementation of the CARE Act was associated with improvements in several measures of patient experience. Policies that formally incorporate caregivers into patient care during hospitalization may improve patient outcomes.
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Affiliation(s)
- Courtney R. Lee
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
- Department of Medicine, Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Elizabeth Taggert
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia
| | - Norma B. Coe
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia
| | - Paula Chatterjee
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
- Department of Medicine, Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
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Williams MV, Li J. Embracing carers: when will adult hospitals fully adopt the same practices as children's hospitals? BMJ Qual Saf 2023:bmjqs-2022-015425. [PMID: 36948545 DOI: 10.1136/bmjqs-2022-015425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 03/24/2023]
Affiliation(s)
- Mark V Williams
- Division of Hospital Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Jing Li
- Division of Hospital Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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Yeo TP, Cannaday S, Thompson RE, Fogg R, Nevler A, Lavu H, Yeo CJ. Distress, Depression, and the Effect of ZIP Code in Pancreaticobiliary Cancer Patients and Their Significant Others. J Am Coll Surg 2023; 236:339-349. [PMID: 36648262 DOI: 10.1097/xcs.0000000000000469] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Distress screening of cancer patients is mandated by the American College of Surgeons Commission on Cancer. Clinical implementation remains limited, particularly in surgical oncology settings in individuals with pancreaticobiliary cancers. STUDY DESIGN This study evaluated differences in mean distress scores based on the National Comprehensive Cancer Network Distress Thermometer & Problem List for patients with pancreaticobiliary cancers, benign pancreatic conditions, and for their significant others (SOs). The distress screening was conducted at the first office visit and postoperatively in a subset of those who had surgery. Distress Thermometer (DT) scores were dichotomized at ≤5 vs >5 and at ≥7 and correlated with Problem List items. The US ZIP Code database was used to correlate income range, percent poverty, and unemployment in the patient's self-identified ZIP code. Regression models were fitted to identify independent predictors of distress. RESULTS A total of 547 patients and 184 SOs were evaluated. Thirty percent of patients had DT scores >5, with pancreatic adenocarcinoma patients reporting the highest levels of distress. SOs of pancreatic adenocarcinoma patients reported even greater distress than the patients themselves. As the number of pre-existing medical problems increased; so did DT scores. Distress correlated with physical and emotional problems and worry about insurance coverage and transportation. Higher income level predicted higher DT scores, although poverty predicted lower DT scores. Depression was present in 12% of the patients. Distress improved in those undergoing surgery. CONCLUSIONS Distress and depression in pancreaticobiliary cancer patients and SOs are prevalent. The findings of this study have multiple actionable implications and require diagnosis, treatment, and referral to supportive care resources.
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Affiliation(s)
- Theresa P Yeo
- From the Jefferson College of Nursing (TP Yeo), Thomas Jefferson University, Philadelphia, PA
- The Jefferson Pancreas, Biliary and Related Cancer Center, Sidney Kimmel Cancer Center (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo), Thomas Jefferson University, Philadelphia, PA
- Thomas Jefferson University, Sidney Kimmel Cancer Center, Philadelphia, PA (TP Yeo, Nevler, Lavu, CJ Yeo)
- Thomas Jefferson University Hospital, Philadelphia, PA (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo)
| | - Shawnna Cannaday
- The Jefferson Pancreas, Biliary and Related Cancer Center, Sidney Kimmel Cancer Center (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo), Thomas Jefferson University, Philadelphia, PA
- Thomas Jefferson University Hospital, Philadelphia, PA (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo)
| | | | - Ryan Fogg
- Sidney Kimmel Medical College, Philadelphia, PA, (Fogg)
| | - Avinoam Nevler
- The Jefferson Pancreas, Biliary and Related Cancer Center, Sidney Kimmel Cancer Center (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo), Thomas Jefferson University, Philadelphia, PA
- Thomas Jefferson University, Sidney Kimmel Cancer Center, Philadelphia, PA (TP Yeo, Nevler, Lavu, CJ Yeo)
- Thomas Jefferson University Hospital, Philadelphia, PA (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo)
| | - Harish Lavu
- The Jefferson Pancreas, Biliary and Related Cancer Center, Sidney Kimmel Cancer Center (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo), Thomas Jefferson University, Philadelphia, PA
- Thomas Jefferson University, Sidney Kimmel Cancer Center, Philadelphia, PA (TP Yeo, Nevler, Lavu, CJ Yeo)
- Thomas Jefferson University Hospital, Philadelphia, PA (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo)
| | - Charles J Yeo
- The Jefferson Pancreas, Biliary and Related Cancer Center, Sidney Kimmel Cancer Center (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo), Thomas Jefferson University, Philadelphia, PA
- Thomas Jefferson University, Sidney Kimmel Cancer Center, Philadelphia, PA (TP Yeo, Nevler, Lavu, CJ Yeo)
- Thomas Jefferson University Hospital, Philadelphia, PA (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo)
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Zheng Y, Anton B, Rodakowski J, Altieri Dunn SC, Fields B, Hodges JC, Donovan H, Feiler C, Martsolf G, Bilderback A, Martin SC, Li D, James AE. Associations Between Implementation of the Caregiver Advise Record Enable (CARE) Act and Health Service Utilization for Older Adults with Diabetes: Retrospective Observational Study. JMIR Aging 2022; 5:e32790. [PMID: 35727611 PMCID: PMC9257609 DOI: 10.2196/32790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/13/2022] [Accepted: 04/24/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The Caregiver Advise Record Enable (CARE) Act is a state level law that requires hospitals to identify and educate caregivers ("family members or friends") upon discharge. OBJECTIVE This study examined the association between the implementation of the CARE Act in a Pennsylvania health system and health service utilization (ie, reducing hospital readmission, emergency department [ED] visits, and mortality) for older adults with diabetes. METHODS The key elements of the CARE Act were implemented and applied to the patients discharged to home. The data between May and October 2017 were pulled from inpatient electronic health records. Likelihood-ratio chi-square tests and multivariate logistic regression models were used for statistical analysis. RESULTS The sample consisted of 2591 older inpatients with diabetes with a mean age of 74.6 (SD 7.1) years. Of the 2591 patients, 46.1% (n=1194) were female, 86.9% (n=2251) were White, 97.4% (n=2523) had type 2 diabetes, and 69.5% (n=1801) identified a caregiver. Of the 1801 caregivers identified, 399 (22.2%) received discharge education and training. We compared the differences in health service utilization between pre- and postimplementation of the CARE Act; however, no significance was found. No significant differences were detected from the bivariate analyses in any outcomes between individuals who identified a caregiver and those who declined to identify a caregiver. After adjusting for risk factors (multivariate analysis), those who identified a caregiver (12.2%, 219/1801) was associated with higher rates of 30-day hospital readmission than those who declined to identify a caregiver (9.9%, 78/790; odds ratio [OR] 1.38, 95% CI 1.04-1.87; P=.02). Significantly lower rates were detected in 7-day readmission (P=.02), as well as 7-day (P=.03) and 30-day (P=.01) ED visits, among patients with diabetes whose identified caregiver received education and training than those whose identified caregiver did not receive education and training in the bivariate analyses. However, after adjusting for risk factors, no significance was found in 7-day readmission (OR 0.53, 95% CI 0.27-1.05; P=.07), 7-day ED visit (OR 0.63, 95% CI 0.38-1.03; P=.07), and 30-day ED visit (OR 0.73, 95% CI 0.52-1.02; P=.07). No significant associations were found for other outcomes (ie, 30-day readmission and 7-day and 30-day mortality) in both the bivariate and multivariate analyses. CONCLUSIONS Our study found that the implementation of the CARE Act was associated with certain health service utilization. The identification of caregivers was associated with higher rates of 30-day hospital readmission in the multivariate analysis, whereas having identified caregivers who received discharge education was associated with lower rates of readmission and ED visit in the bivariate analysis.
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Affiliation(s)
- Yaguang Zheng
- Meyers College of Nursing, New York University, New York, NY, United States
| | - Bonnie Anton
- Wolff Center at University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Juleen Rodakowski
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Beth Fields
- Department of Kinesiology, School of Education, University of Wisconsin-Madison, Madison, WI, United States
| | - Jacob C Hodges
- Wolff Center at University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Heidi Donovan
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Grant Martsolf
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrew Bilderback
- Wolff Center at University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Susan C Martin
- Wolff Center at University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Dan Li
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Alton Everette James
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
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Semere W, Cemballi AG, Schillinger D, Casillas A, Lemberg M, Lyles CR. "We need to bring them out from the shadows:" A qualitative study of safety net physician leaders' perspectives on caregivers. PATIENT EDUCATION AND COUNSELING 2022; 105:1663-1670. [PMID: 34756473 PMCID: PMC9033884 DOI: 10.1016/j.pec.2021.10.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/23/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To explore physician leaders' perspectives on processes and priorities for engaging with caregivers in their clinical practices as well as within their safety net health systems. METHODS We conducted in-depth semi-structured interviews with primary care physicians in care management leadership at three California safety net health systems. Interviews explored physicians' experiences managing medically and socially complex patients with caregivers. Using thematic analysis, two qualitative researchers independently analyzed interview transcripts and established consensus with the broader research team through iterative input to derive major themes. RESULTS Fifteen physicians completed interviews. Nine participants were women, 8 were White and 10 reported Spanish language proficiency. Participant interviews generated six major themes: challenges uncovering caregiver identities, recognizing variation in caregivers' roles, adapting visit communication strategies to include caregivers, engaging caregivers in patient care, and caring for the caregiver. CONCLUSIONS Engaging caregivers is challenging given the limited recognition of caregiver involvement in patient care by health systems. Adapting visit communication to include caregivers requires bridging language and literacy barriers. PRACTICE IMPLICATIONS Developing mechanisms to enable the consistent identification of patients' caregivers, facilitate ongoing communication with caregivers, and extend support for them could improve outcomes for vulnerable patients and their families.
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Affiliation(s)
- Wagahta Semere
- Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA; Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA, USA.
| | - Anupama G Cemballi
- Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA; Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA, USA
| | - Dean Schillinger
- Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA; Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA, USA
| | - Alejandra Casillas
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Miya Lemberg
- Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA, USA
| | - Courtney R Lyles
- Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA; Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA, USA
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Carbery M, Schulz R, Rodakowski J, Terhorst L, Fields B. Evaluating the Appropriateness and Feasibility of the Care Partner Hospital Assessment Tool (CHAT). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13355. [PMID: 34948961 PMCID: PMC8707854 DOI: 10.3390/ijerph182413355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/12/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022]
Abstract
Hospital practitioners rely on care partners of older adults to provide complex care without identifying and addressing their needs. The Care Partner Hospital Assessment Tool (CHAT) was developed to identify the education skill training needs of care partners of hospitalized older adults. This two-phased mixed-method study evaluated the appropriateness and feasibility of the CHAT. The phase 1 quantitative survey with caregiving experts indicated 70-100% agreement for the length and helpfulness of the CHAT (n = 23). These results were supported by phase 2 qualitative interviews with hospital administrators and practitioners, which revealed the following themes: (1) intuitive and clear design worth sustaining and (2) concerns and proposed solutions for implementation. Findings suggest the CHAT is an appropriate and feasible tool for hospital practitioners to tailor their education and skills training to address care partners' needs. Identifying care partners' needs is an important step in ensuring they are prepared to complete their caregiving responsibilities.
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Affiliation(s)
- Madeline Carbery
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI 53706, USA;
| | - Richard Schulz
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Juleen Rodakowski
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA 15260, USA; (J.R.); (L.T.)
| | - Lauren Terhorst
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA 15260, USA; (J.R.); (L.T.)
| | - Beth Fields
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI 53706, USA;
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Carbery M, Schwartz S, Werner N, Fields B. Education and skills training for care partners of hospitalised older adults: A scoping review. HEALTH EDUCATION JOURNAL 2021; 80:921-933. [PMID: 37131526 PMCID: PMC10150946 DOI: 10.1177/00178969211034192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background The care partners of hospitalised older adults often feel dissatisfied with the education and skills training provided to them, resulting in unpreparedness and poor health outcomes. Objective This review aimed to characterise and identify gaps in the education and skills training used with the care partners of older adults in the hospital. Methods We conducted a scoping review on the education and skills training practices used with the care partners of hospitalised older adults in the USA via sources identified in the PubMed, PsychINFO and CINAHL databases. Results Twelve studies were included in this review. Results illustrate that nurses utilise multiple modes of delivery and frequently provide education and skills training tailored to the needs of care partners at the latter end of hospital care. The provision of education and skills training varies greatly, however, including who provides education, in what way information is conveyed, and how care partner outcomes are measured. Conclusion This is the first scoping review to describe and synthesise the education and skills training practices used with care partners of hospitalised older adults. Findings highlight the need for education and skills training to be interprofessional, tailored to individual care partners' needs and begin at, or even before, the hospital admission of older adult patients.
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Affiliation(s)
- Madeline Carbery
- Department of Kinesiology, University of Wisconsin–Madison, Madison, WI, USA
| | - Samantha Schwartz
- Department of Kinesiology, University of Wisconsin–Madison, Madison, WI, USA
| | - Nicole Werner
- Department of Industrial and Systems Engineering, University of Wisconsin–Madison, WI, Madison, USA
| | - Beth Fields
- Department of Kinesiology, University of Wisconsin–Madison, Madison, WI, USA
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