Integrating family caregivers in older adults’ hospital stays: a needed cultural shift

ABSTRACT

Objectives

This study aimed to examine perceived barriers and facilitators to caregiver inclusion in the hospital care of older adult family members or friends through the perspectives of (1) hospitalized older adults, (2) caregivers of a hospitalized older adult, (3) healthcare clinicians, and (4) policymakers.

Methods

This qualitative descriptive exploratory study utilized semi-structured interviews with N = 24 participants and was analyzed using a framework method.

Results

Eight codes arose that were categorized into four domains guided by the Social Ecological Model. Individual-level factors were determined both for the caregiver and for the clinician. Relationship-level factors were revealed pertaining to communication style and method. Hospital-level factors included hospital environment and resources. Societal-level factors included healthcare climate and policies.

Discussion

Findings indicated that hospital workflows and policies inadequately support family caregivers. This study highlights potential solutions to caregivers’ integration into hospital workflows.

KEYWORDS:

• Healthcare policy
• CARE Act
• policy implementation
• qualitative methods
• Caregiving

Acknowledgments

We would like to thank all participants who shared their perspectives and experiences within this research study. We are grateful for the contribution of our research staff, Anne Mortensen, for assisting our recruitment efforts. We thank our collaborating healthcare system, UW Health, members of the Board of Older Adult Advisors, as well as the Center for Aging Research and Education at the University of Wisconsin-Madison.

Author contributions

BF conceived of the presented idea. CM completed all aspects of data collection. AK, AA, and NM provided feedback about the planning and development of the research. CM, MA, and AK conducted data analysis. CM took the lead on writing the manuscript with input and advising from all authors.

Declaration of financial/other relationships

AA receives funding from Blue Note Therapeutics and Beigene.

NM is a Cambia Health Foundation Sojourns Scholar (2021 Cohort).

AK is supported by an award from the National Institutes of Health/National Cancer Institute (T32CA009461) and acknowledges Cancer Center Support Grant P30 CA008748 from the National Institutes of Health/National Cancer Institute.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Notes

1. Family caregiver includes a traditional family, partner, or other support person designated by an older adult care recipient. Although some prefer to use the terms care partner or informal caregiver, family caregiver is more commonly used and accepted in north American healthcare delivery systems (RAISE Ace Family Caregiving Council & The Advisory Council to Support Grandparents Raising Grandchildren, 2022).

Additional information

Funding

This research was funded by the Office of the Vice Chancellor for Research and Graduate Education at the University of Wisconsin-Madison.