Care home admission from hospital settings – a poorly understood experience

J.K. Harrison, J McArthur, Azucena Garcia Garrido, A Logan, Sarah Rhynas, Alasdair Maclullich, Susan Shenkin

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Moving into a care home is a significant event for any individual and their family, but one which can be a necessary way to address care needs which cannot be supported in the community. UK health policy documents advise that care home admission from acute hospital settings should be avoided. However, although this is a common outcome of hospital admission for which there appears to be significant variation in UK practice, this has been under-researched and is poorly understood.
We conducted a cohort study using case-note review to describe 100 individuals who experienced this transition and describe their in-hospital care and assessment. Our findings demonstrated variations in the inpatient experiences, with some having long inpatient stays, multiple transfers of care and concerningly low levels (37%) of documented involvement of the individual in this life-changing decision. This population have high levels of delirium and dementia and these conditions must be detected and taken account of in the decision-making process.
We describe recommendations which can be actioned. In particular we need to consider how to ensure we involve adults with cognitive impairment in decision-making and we need to improve documentation of significant conversations and evidencing person-centred care. Further research is needed to better understand why individuals are admitted to care homes from hospitals and we need to involve patients, their families and members of the multidisciplinary team to hear their perspectives to define best practice in this area.
Original languageEnglish
JournalNursing Times
Early online date31 May 2017
Publication statusE-pub ahead of print - 31 May 2017


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