[Admission and discharge of people with dementia- Communication from the perspective of respite care experts]

Handover between home and respite care concerning people with dementia: An online survey

INTRODUCTION

Respite care for people with dementia is increasingly promoted. However, little is known about the safety-relevant aspects of handover between home and respite care facilities for people with dementia. We thus focus on the safety-relevant information exchange taking place at the admission to and the discharge from respite care and discuss the need for improvement.

METHODS

A pilot online survey with staff in management positions in different types of respite care facilities in Germany was conducted between April and June 2014. The questionnaire contained 65 (open and closed) questions. The answers were submitted to explorative data analysis using descriptive statistics and qualitative content analysis.

RESULTS

50 respite care facility management staff participated. Nearly half of them reported involving external healthcare professionals (e.g., physicians). The results showed that early identification of informal caregivers or people with dementia in need of support (e.g., so-called red flags) is poorly addressed. Often, there are no medical, medication- and handover-related documents. Information delivery deadlines are not clearly defined. Only 38 % of the participating respite care facilities reported regular measurement of the information exchange quality, and only 15 % of the management staff reported that they conducted follow-up calls. Most participants reported having standardized procedures.

CONCLUSION

Handover between home and respite care facilities for people with dementia needs to be improved. Information delivery deadlines must be clearly defined. Communication training for respite care staff, including narrative intake methods, could enhance data collection at admission. Overall improved coordination between the parties involved would have a positive impact on safety-relevant aspects of information exchange.

[Handover between home and respite care facilities : Delphi survey within the context of continuity of care for people with dementia]

BACKGROUND

Criteria for the handover between healthcare settings were identified based on a review and on results of empirical data.

AIM

This study was carried out to select the most relevant criteria for defining the quality of continuity of care of people with dementia (PwD) in the context of the handover between care at home and respite care facilities.

MATERIAL AND METHODS

A modified classical two-step Delphi design was used in combination with a group Delphi design.

RESULTS

A total of 28 core criteria with a consensus strength of > 60 % are presented. Safety-relevant information, especially the personal habits of PwD and the role of informal caregivers in the handover between care settings are important. Furthermore, the following general principles to ensure the quality of continuity of the care of PwD were deduced: completeness, verification, multipath communication, timeliness and topicality, accessibility and defined responsibilities, roles and standardization.

DISCUSSION

A successful transition of PwD to respite care facilities relies on the provision of relevant information, considering personal habits, before the day of transition. Furthermore, a timely preparation for discharge is important. The individual needs of the informal caregivers with regard to their support should be considered. Professionals who are responsible in handover processes should have solid communication competence in order to collect relevant information from informal caregivers, who have a strong individual care experience with the PwD.