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Title: Older people and their carers' perspectives of causes and risk factors to hospital readmissions
Author: Henry-Nweye, Roseline Awhoma
ISNI:       0000 0004 2737 2867
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2011
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Emergency readmission to hospital is one of the greatest pressures on the National Health Service and research shows that 40% are avoidable (Department of Health 2000; Nikolaus et al 1992, ONS 2002;). Hospital read missions have generally been researched form a quantitative approach and perceived as unavoidable or avoidable. For example, evidence suggests that unavoidable read missions are caused by relapse of chronic disease, the changes in family life and the effect of limitation of primary care services!-..(11ound et al 2002; Dobrzanska & Newell, 2006) while the avoidable read missions 'are due to non- involvement in carers, unresolved health problems on discharge, lack of support in the homes, and poor communication across sectors of health care (Buell 2008, Gravelle et al 2007,). However, there is a lack of research on older people and their carers perceived reasons for readmissions. Aim; The overall purpose of this study was to explore individual older person and their carers' perceptions of hospital read missions, with the goal of providing evidence for the development of safe and effective intervention strategies to decrease costly hospital read missions for older patients in the United Kingdom. Methodology; Qualitative method, with a descriptive phenomenological approach was used as the research design. The setting for the study was in the community where in-depth interviews with older people and their main carers were conducted and used as to access and explore their experiences regarding health and social care services at home after initial hospital discharge. Analysis; The purposive sample consisted of 30 in-depth interviews with nineteen older people who had been discharged from hospital and eleven of their carers. The older people are 65years and over, all lived within Liverpool, Halton and St Helen's Primary Care Trusts in the North West of England in the United Kingdom. Interviews were audio-recorded and transcribed, and were analysed thematically. Results; Participants reported a preference for care to be delivered to them in their homes. The problems identified are lack of empowerment and involvement in care suggesting a need for additional individualised support at home. Additionally, inadequacy of care provision, overburden and lack of supports to informal carers' is also highlighted. The resultant effect is that older people were making hurried, life- changing decisions to move into sheltered accommodation, residential or nursing homes. Discussion; In order to control hospital read missions, the author recommends that those in charge of policy-making for continuing care of older people in the community should direct health practitioners to provide individualised support to older people after discharge from hospital. Some recommended services could include health risk assessment, routine health screening which includes nutrition screening and counselling, health promotion programs, home injury control services, depression and mental health screening and medication management and counselling. The study revealed that care at home is possible with support from 10 I family members/friends, with the implication that those without families should be considered for care elsewhere. Key words: old people, elder people, older people, seniors, geriatric, Hospital readmission, unplanned readmission, readmissions, systematic literature review, home care, hospital discharge to community, community rehabilitation, hospital to home. 11
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available