Tabitha Thomas1, Isla Kuhn2, Stephen Barclay3. 1. 1 Arthur Rank Hospice, Cambridge, UK. 2. 2 Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, UK. 3. 3 Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Abstract
BACKGROUND: Transfers from hospital or 'hospice palliative care units' to care homes for end-of-life care are an increasingly common part of clinical practice but are a source of anxiety and distress for patients, relatives and healthcare professionals. AIM: To understand the experiences of patients discharged to care homes for end-of-life care. DESIGN: Systematic review and narrative synthesis of the UK literature concerning inpatient transfer from a hospital or hospice palliative care unit to a care home for end-of-life care. RESULTS: The published literature is very limited: only three papers and one conference abstract were identified, all of low quality using Gough's weight of evidence assessment. No papers examined transfer from hospital: all were of transfers from hospices and were retrospective case note reviews. Many patients were reported to have been negative or ambivalent about moving and experienced feelings of anxiety or abandonment when transferred. Relatives were often either vehemently opposed or ambivalent. Although some came to accept transfer, others reported the transfer to have seriously affected their loved one's quality of life and that the process of finding a care home had been traumatic. No studies investigated patients' views prospectively, the views of staff or the processes of decision-making. CONCLUSION: The UK literature is very limited, despite such transfers being an increasingly common part of clinical practice and a source of concern to patients, relatives and staff alike. Further research is urgently needed in this area, especially studies of patients themselves, in order to understand their experiences and views.
BACKGROUND: Transfers from hospital or 'hospice palliative care units' to care homes for end-of-life care are an increasingly common part of clinical practice but are a source of anxiety and distress for patients, relatives and healthcare professionals. AIM: To understand the experiences of patients discharged to care homes for end-of-life care. DESIGN: Systematic review and narrative synthesis of the UK literature concerning inpatient transfer from a hospital or hospice palliative care unit to a care home for end-of-life care. RESULTS: The published literature is very limited: only three papers and one conference abstract were identified, all of low quality using Gough's weight of evidence assessment. No papers examined transfer from hospital: all were of transfers from hospices and were retrospective case note reviews. Many patients were reported to have been negative or ambivalent about moving and experienced feelings of anxiety or abandonment when transferred. Relatives were often either vehemently opposed or ambivalent. Although some came to accept transfer, others reported the transfer to have seriously affected their loved one's quality of life and that the process of finding a care home had been traumatic. No studies investigated patients' views prospectively, the views of staff or the processes of decision-making. CONCLUSION: The UK literature is very limited, despite such transfers being an increasingly common part of clinical practice and a source of concern to patients, relatives and staff alike. Further research is urgently needed in this area, especially studies of patients themselves, in order to understand their experiences and views.
Authors: Aluem Tark; Leah V Estrada; Mary E Tresgallo; Denise D Quigley; Patricia W Stone; Mansi Agarwal Journal: Palliat Med Date: 2020-03-10 Impact factor: 4.762
Authors: Daniel Nadales Rodríguez; Guillermo Bermúdez-González; Ismael Pablo Soler-García Journal: Int J Environ Res Public Health Date: 2022-07-28 Impact factor: 4.614