Discharging older patients from convalescent hospitals: Information needs of family members to inform the development of eLIP

Abstract

The use of computerized technology to retrieve information about health and social care has advanced to enable consumers to access resourceful knowledge and improve patient outcomes. With information becoming so widely distributed, there is an overwhelming feeling about where to begin. Discharge planning of hospitalized older patients is known to be a daunting time and haste decisions are made based on limited time and information. A 4-year study aims to develop an eLearning Information Package (eLIP) as part of a pre-discharge hospital programme. Phase 1 study was conducted using individual interviews with older patients, family members and nurses to examine information they considered to be useful in planning discharge for older patients and would inform the development of eLIP. This presentation is based on findings from 27 family members about specific information they wanted to know and sources of information about supportive services that would be helpful in planning an elder for discharge home. Family members were conveniently recruited after their older relatives were admitted into one of eight medical wards of two convalescent hospitals in Hong Kong. Findings revealed that discharge planning was inhibited by the limited communication between health care professionals and families. Families described being uninformed about the patient’s medical condition and were passive about approaching healthcare professionals to request for this information. There were uncertainties about ‘what’ and ‘how’ to ask questions. The delay in receiving information prevented families from initiating discharge plans. Denying and underestimating the elder’s condition arose. Specific information about illness and progress should be initiated and explained by the health care professionals so as to psychologically prepare the family about the elders’ changing circumstances. Elder’s ability to perform ADL was useful information for families to monitor deterioration/improvement in the elder’s health status and to identify areas for health teaching. Families knew little about supportive services available in the community. There was a high reliance on prior knowledge and experiences. Beyond identifying the names of the service, many did not know how to find information about the scope of services, fees and contacts. Sources of information were obtained from the media, advertisements, friends and leaflets. Providing families with a list of organisation’s names was common practice in hospitals. Timely provision of information to families in a format that is simple and readily accessible is highly recommended to enable them to accept the elders changing health needs and provide adequate time to explore placement options and service preferences in pre-discharge planning. In a time-constrained and busy ward, the role of an innovative e-learning technological platform will be developed to bridge health and social care services.