Dementia Care Research and Psychosocial Factors

Area of Science:

• Gerontology
• Dementia Care
• Health Services Research

Background:

• Hospital-to-home transitions are complex for older adults (65+) with dementia and comorbidities.
• These transitions risk patient safety due to errors, miscommunication, and delays, increasing mortality, morbidity, and readmissions.

Purpose of the Study:

• To synthesize literature on hospital-to-home transitions for older adults with dementia and comorbidities.
• To develop a realist framework explaining how, for whom, and to what extent these transitions function for this population.

Main Methods:

• Systematic search of nine electronic databases (e.g., MEDLINE, Scopus).
• Inclusion of peer-reviewed and grey literature focusing on transitions for older adults with dementia and comorbidities.
• Synthesis of context, mechanism, and outcome interactions to develop a framework.

Main Results:

• A five-component framework was developed: dementia care management, knowledge, standards, system, and family/friend roles.
• Caregivers faced increased burden, while healthcare professionals lacked dementia-specific knowledge and training.
• Inadequate information transfer, fragmented care pathways, and insufficient collaboration led to delays and unsafe discharges.

Conclusions:

• Hospital-to-home transitions for this population are complex with no easy solutions.
• A framework highlights the need for system-level changes and tailored interventions.
• Improvements aim to enhance care continuity, patient safety, and support for those involved in post-discharge care.