Barriers and Strategies for Recruiting Care Partners During the Hospitalization of People Living with Dementia:...

Background: Recruiting care partners (CPs) of hospitalized people living with dementia is challenging due to rapid discharge timelines and complex inpatient workflows. This study identified barriers to CP recruitment encountered during the first year of a hospital-based randomized controlled trial and the strategies implemented in response to them. Methods: A qualitative descriptive study using thematic analysis of twelve study coordination and implementation meeting transcripts was conducted. Recruitment outcomes were examined to assess changes before and after implementation of the enhanced recruitment workflow. Results: Eight recruitment barriers were identified, including fragmented electronic health record (EHR) documentation, uncertainty in CP presence, limited clinician availability, passive study promotion, and inefficient clinical-research team collaboration. Nine strategies were developed and implemented in response to these barriers. The enhanced recruitment workflow was temporally associated with an increase in average monthly enrollment from 0.25 participants (April-July 2024) to 4 participants (August 2024-December 2025). Over the same periods, the cumulative enrollment rate was 3% and 23%, respectively. Conclusions: Care partner recruitment in inpatient settings is highly context-dependent and requires iterative, implementation-informed adaptation. Effective recruitment may be supported by embedding processes into routine inpatient workflows, clarifying recruitment roles, leveraging EHR-supported identification, and maintaining close clinical-research team collaboration to respond to the unpredictable presence of care partners and short discharge windows.