Voice: The Views of Informal Caregivers and the Elderly: A Qualitative Study of the Post-Hospital Experience

Date of Degree

5-2023

Document Type

Dissertation

Degree Name

Doctor of Business Administration (DBA)

Program

Business Administration

Advisor

Diana Garza

Advisor

Annette Craven

Advisor

Adam Guerrero

Abstract

Research Focus The trending increase in the elderly population, inherent age-related health conditions, and hospital initiatives culminate in an increased rate of hospital-to-home transitions for the elderly population. As a result, the elderly depend on informal family care throughout their post-hospital discharge transition. Furthermore, there is empirical evidence that inadequate and misaligned transitions considerably impact elderly patients and their informal caregivers. Therefore, the healthcare industry has identified patient experience as the key indicator of quality and continuity of care.

The problem is that only quantitative surveys are the standard method for examining patient experience. Therefore, it is imperative to gain deeper insight through a qualitative exploration to understand the post-hospital discharge phenomenon from elderly patients and their informal caregivers (ICs) perspectives.

This qualitative phenomenological study aimed to gain qualitative knowledge of how post-hospital discharge to home is experienced from the patient and informal caregiver perspective. The Meleis Transitions Theory was employed as the theoretical framework as it aligns with multidimensional factors and the individuality of the post-hospital discharge (PD) phenomenon.

Research Method

The study postulated two research questions. First, how do geriatric patients describe the lived experiences of post-discharge? Second, how do informal caregivers of PD geriatric patients describe their lived experiences? The participants were selected through purposive and snowball strategies from a university in the southwest region of the United States. Narrative data were ethically obtained through one-on-one semi-structured interviews with each participant and analyzed with NVivo software. The results revealed four superordinate elderly patient themes and four superordinate informal caregiver themes.

Research Findings

The study's findings affirm that the success of elderly posy-hospital discharge (PD) is heavily dependent on the involvement of informal caregivers. Furthermore, the study finds that optimal elderly PD experiences are attainable and best achieved with professional health care and informal family care. However, PD transition planning often overlooks informal caregivers and their needs resulting in stressful PD experiences for informal caregivers. This study revealed barriers and facilitators to propitious PD experiences for the elderly and informal caregivers. When the PD transition is less than optimal, the elderly and informal caregivers are impacted physically, emotionally, and psychologically.

Conclusions From Research

The study's findings validate the theoretical framework that post-hospital discharge (PD) is a multifactorial transition that requires individualized transition planning to optimize patient experience and outcomes. However, this investigation identified additional associative factors that influence how elderly PD is experienced. Therefore, policymakers are encouraged to implement a mixed methods approach to collecting and measuring patient experience. Furthermore, practitioners are encouraged to engage with elderly patients and their informal caregivers and apply a biopsychosocial approach, and complete an informal caregiver profile when developing post-hospital discharge transitions for the elderly. Ultimately, the study concludes that a comprehensive and family-centered care approach is required to design post-hospital discharge transitions tailored to the needs of elderly patients and informal caregivers.

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