Transition from Hospital to Home-Based Care for Older Adults in Southwestern Uganda: Informal Caregiver’s Experiences

Abstract

Background

The transition from hospital-based to home-based care is a complex and challenging process. In most developing countries, patients transfer directly from hospital to home immediately after stabilizing from acute illness. After discharge, all the patient’s care needs are taken over by informal caregivers whose experiences and practices may directly or indirectly impact the quality of patient care as well as the outcomes. This study aimed at exploring the experiences of informal caregivers during the hospital to home transition process of older adults.

Methods

We conducted a qualitative exploratory study that used one-on-one interviews to describe individual experiences of care givers of older adults admitted in a clinical care setting. We interviewed caregivers of older adults with diabetes and of hypertension who were admitted at the inpatient department of internal medicine at Mbarara regional referral hospital (MRRH). All audio recorded interviews were transcribed verbatim by the research assistant in the local dialect and back translated into English the official language spoken in Uganda. The study utilized content analysis approach to analyze 23 interviews conducted.

Results

Of the 23 participants interviewed, majority were aged between 20 and 40 years and females. Three major themes emerged from the data: informal caregivers’ experience during hospitalization, experience during preparation for discharge and experience after discharge.

Conclusion

Caregiver experience during hospitalization influences their involvement and compliance with the discharge process which in turn affects their ability to deliver quality post discharge care to the patient. Healthcare systems need to put targeted effort and resources in the discharge process and home follow-up visits to improve home-based care by caregivers. Community-based geriatric care centers can bridge the care gap during transition from hospital to home-based care.