Facilitating Discharge Planning through reinforcement of assistive device preparation in caregivers of older patients

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Authors (including presenting author) :
Mui HY(1), Chan HF(1), Fung KK(1), Wan KY(1)
Affiliation :
(1)Occupational Therapy Department, TWGHs Fung Yiu King Hospital
Introduction :
It is essential to recognize the role of family and caregivers in caring and in post-discharge preparation for older patients. Evidence suggests that comprehensive discharge planning that involves both patients and caregivers is related to shorter hospital stays (Bauer, M., Fitzgerald, L., et. al, 2009). To facilitate early involvement in discharge planning, a pilot assistive device introduction group for caregivers was developed in order to equip them with comprehensive information on assistive devices for earlier preparation of post-discharge care for the patients.
Objectives :
1. To enhance knowledge sharing and skill practice of assistive device usage in a group format in addition to the existing caregiver education 2. To improve the readiness of caregivers in post-discharge care by earlier preparation of assistive devices
Methodology :
Caregivers of patients with potential to be discharged home in orthopedics and medical wards in TWGHs Fung Yiu King Hospital (FYKH) were recruited to attend the weekly assistive device introduction group early after patient’s admission. The main content included: (1) Introduction of common assistive devices (2) Explanation and demonstration of the use of the common assistive devices (3) Information related to access to the devices including on-loan service from FYKH occupational therapy department, community on-loan service (4) Question and answer session and feedback collection.
Result & Outcome :
27 groups were conducted with 63 caregivers attended the group (from 6 December 2017 to 10 October 2018). Early recruitment of caregivers to attend the group was emphasized. The average period from patient admission to caregiver attending the group is 8.7 days while the average length of stay of this group of patients was 23 days. The overall feedback from caregivers was positive. (1) 83% of the caregivers agreed that the group could facilitate understanding towards assistive devices and enhance their confidence in assisting patients in daily activities when discharge home (2) 78% of the caregivers agreed that the group could facilitate discharge planning. Among all patients involved, 68.5% patients were discharged back home with support by caregivers. The pilot assistive device introduction group enhanced caregivers’ competence in caring and facilitated discharge planning. The additional assistive device knowledge sharing and skill demonstration and practice conducted in the group format is effective in preparing the discharge preparation process and reinforcing skill acquisition. Reference: Bauer, M., Fitzgerald, L., Haesler, E., & Manfrin, M. (2009). Hospital discharge planning for frail older people and their family. Are we delivering best practice? A review of the evidence. Journal of clinical nursing, 18(18), 2539-2546.

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