Hospitals and care homes need to ‘ease patients’ transition’

Hospitals and nursing homes need to co-operate more and communicate better in order to ease the transition of patients moving to long-term care, according to a new report.

In some cases, especially in urban areas, patients move directly from hospital to a nursing home but are not given a choice in the decision-making process, the report by researchers in the University of Ulster says.

Public perceptions and the use of ageist terms such as “elderly” and “institutions” need to be challenged because they perpetuate stereotypes that mitigate against quality care provision for older people, it says.

Because high staff turnover can lead to a loss of personal knowledge of residents, nursing homes should consider more creative way of retaining staff in order to maintain continuity of care.

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‘Homely experience’

Staff interviewed for the study felt there was too much focus on clinical and medical matters in nursing homes, thereby detracting from the "homely" experience. They also expressed frustration about regulatory and inspection processes and said there was an urgent need for the Health Information Quality Authority and the nursing home sector to work in partnership to address these issues.

“While both parties have a remit for the maintenance of standards, it appears that much more can be done to ensure that the inspection process does not have adverse consequences for residents and staff.”

The study, commissioned by Nursing Homes Ireland, focuses on the meaning of what constitutes "home" from the perspective of residents of nursing homes. Co-author Prof Assumpta Ryan says nursing homes can present a very positive life choice for many older people.

“The challenge is not to try and replace a person’s interpretation of home, but to focus upon ensuring the nursing home is perceived as their new home. There is a need for strong co-operation and effective communication between family, health services and support workers, and wider society to create greater awareness and assurance surrounding older people’s transitions to nursing home care.”

‘Unfair’

Dr Ryan says “unfair” ageism and stigma around nursing home care are exacerbated by a belief that admission to a home is viewed as “the end-phase of an older person’s trajectory”.

Nursing homes residents interviewed for the study identified concepts such as dignity, respect and the promotion of independence as central to the provision of effective care. “Maintaining a level of independence appeared to be a core component of individuality as was the importance of involvement and choice in decision making.”

Almost 100 residents and staff were interviewed for the study, which will be launched by Minister for Older People Jim Daly on Wednesday.

About 28,000 people live in public and private nursing homes in Ireland, more than half of whom are aged 85 years and over.