Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-26T08:22:50.551Z Has data issue: false hasContentIssue false
  • English
  • Français

Determinants of Health in Discharge Planning for Seniors: Asking the Right Questions

Published online by Cambridge University Press:  20 August 2013

Lisa J. MacNaughton-Doucet
Lisa J. MacNaughton-Doucet*
Affiliation:
Dalhousie University School of Nursing
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Lisa J. MacNaughton-Doucet, R.N., M.N. Dalhousie University School of Nursing 55 Vancouver Street Yarmouth, NS B5A 2P5 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Practitioners are encouraged to consider a shift in their philosophy regarding the manner in which interdisciplinary health care teams ask questions of seniors and their caregivers in the hospital discharge process. By engaging with a discharge framework that encompasses a social-determinants-of-health lens, discharge planning teams can begin to systematically ask questions that move beyond the traditional medical focus on prescriptions, rehabilitation, and treatments. This approach may reveal strengths and also expose health and social inequities that seniors might face upon their arrival home. This information may open a gateway for connecting seniors to social and economic resources that will support them in remaining productive and healthy.

Résumé

Les praticiens sont encouragés à envisager un changement de perspective philosophie sur la façon dont les équipes interdisciplinaires interrogent les personnes âgées et leurs soignants au cours du processus de la sortie de l’hôpital. Les équipes engagées dans le planification des congés de l’hôpital peuvent commencer systematiquement à poser des questions qui vont au-delà du mise au point médical traditionnel sur les prescriptions, la réhabilitation et les soins, s’ils sont engagés dans un cadre de la décharge englobant attention aux déterminants sociaux de la santé. Une telle approche pourrait révéler les points forts et aussi pourrait exposer les inégalités sanitaires et sociales que les aînés doivent confronter en arrivant chez eux. Cette information peut ouvrir une porte d’entrée reliant les personnes âgées aux ressources sociales et économiques qui les soutiennes afin qu’elles puissent rester en bonne santé et productives.

Keywords

agingchronic illnessdischarge planningseniorssocial determinants of healthvieillissmentinvalidité naturelleplanification de congés de l’hôpitalpersonnes âgéesdéterminants sociaux de la santé
Type
Policy and Practice Note / Note de politique et practique
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 32 , Issue 3 , September 2013 , pp. 307 - 315
Copyright
Copyright © Canadian Association on Gerontology 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bassett, R., Bourbonnais, V., & McDowell, I. (2007). Living long and keeping well: Elderly Canadians account for success in aging. Canadian Journal on Aging, 26(2), 113–126.Google Scholar
Bayliss, E., Ellis, J., & Steiner, J. (2007). Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities. Annals of Family Medicine, 5(5), 395–402.Google Scholar
Billings, D., & Kowalski, K. (2008). Transition from hospital to home care: What gets lost between the discharge plan and the real world? Journal of Continuing Education in Nursing, 39(5), 198–199.Google Scholar
Bowles, K., & Cater, J. (2003). Screening for risk of rehospitalization from home care: Use of the outcomes assessment information set and the probability of readmission instrument. Research in Nursing & Health, 26, 118–127.Google Scholar
Canadian Institute for Health Informatics (2009). Analysis brief: Experiences with primary health care. Retrieved July 16, 2013, fromhttp://secure.cihi.ca/cihiweb/products/cse_phc_aib_en.pdf.Google Scholar
Canadian Institute of Health Informatics (2010). Series on Seniors: Seniors and Falls. Retrieved July 16, 2013, fromhttp://www.cihi.ca/CIHI-ext-portal/pdf/internet/SENIORS_FALLS_INFO_EN.Google Scholar
Canadian Institute of Health Informatics (2012). All-Cause Readmission to Acute Care and Return to the Emergency Department. Retrieved July 16, 2013, fromhttps://secure.cihi.ca/free_products/Readmission_to_acutecare_en.pdf.Google Scholar
Carrière, Y., & Légaré, J. (2000). Unmet needs for assistance with ADLs and IADLs: A measure of healthy life expectancy. Social Indicators Research, 51(1), 107–123.Google Scholar
Chen, C., Tang, T., Wang, C., & Guan-Hua, H. (2009). Trajectory and determinants of nutritional health in older patients during a six month post-hospitalization. Journal of Clinical Nursing, 18, 3299–3307.Google Scholar
Coleman, E. A., & Boult, C. (2003). Improving the quality of transitional care for persons with complex care needs. Journal of the American Geriatrics Society, 51(4), 556–557.Google Scholar
Commission on Social Determinants of Health. (2007). Achieving health equity: From root causes to fair outcomes. World Health Organization. Retrieved July 16, 2013, from http://whqlibdoc.who.int/publications/2007/interim_statement_eng.pdf.Google Scholar
Commission on Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, Switzerland: World Health Organization. Retrieved July 16, 2013, from http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf.Google Scholar
Conference Board of Canada. (2012). Health: Life expectancy. Retrieved from http://www.conferenceboard.ca/hcp/details/health/life-expectancy.aspx#expectancy.Google Scholar
Connolly, M., Deaton, C., Dodd, M., Grimshaw, J., Hulme, T., Everitt, S., et al. (2010). Discharge preparation: Do healthcare professionals differ in their opinions? Journal of Interprofessional Care, 24(6), 633–643.Google Scholar
Davis, K. (2011). Social determinants of health in Canada: A treadmill of progress, (Volume 708). Ontario Health Promotion E-Bulletin website. Retrieved fromhttp://www.ohpe.ca/node/12295.Google Scholar
Dedhia, P., Kravet, S., Bulger, J., Hinson, T., Sridharan, A., Kolodner, K., et al. (2009). A quality improvement intervention to facilitate the transition of older adults from three hospitals back to their homes. Journal of the American Geriatrics Society 57, 1540–1546.Google Scholar
Denton, F., & Spencer, B. (2010). Chronic health conditions: Changing prevalence in an aging population and some implications for the delivery of health care services. Canadian Journal on Aging, 29(1), 11–21.Google Scholar
Dhalla, I. A., O’Brien, T., Ko, F., & Laupacis, A. (2012). Toward safer transitions: How can we reduce post-discharge adverse events? Healthcare Quarterly, 15, 63–67.Google Scholar
Fabre, V., Buffington, A., Altfeld, S., Shier, G., & Golden, R., (2011). Social work and transitions of care: Observations from an intervention for older adults. Journal of Gerontological Social Work, 54, 615–626.Google Scholar
Gadalla, T. M. (2009). Sense of mastery, social support, and health in elderly Canadians. Journal of Aging and Health, 21(4), 581–595.Google Scholar
Goodridge, D., Lawson, J., Rennie, D., & Marciniuk, D. (2010). Rural/urban differences in health care utilization and place of death for persons with respiratory illness in the last year of life. Rural and Remote Health, 10(2), 1329–1359.Google Scholar
Green, R., Williams, P., Johnson, C., & Blum, I. (2008). Can Canadian seniors on public pensions afford a nutritious diet? Canadian Journal on Aging, 27(1), 69–79.CrossRefGoogle Scholar
Grimmer, K., Moss, J., Falco, J., & Kindness, H. (2006). Incorporating patient and carer concerns in discharge plans: The development of a practical patient-centred checklist. The Internet Journal of Allied Health Sciences and Practice, 4(1), 1–8.Google Scholar
Gruneir, A., Irfan, D., van Walraven, C., Fischer, H. D., Camacho, X., Rochon, P. A., et al. (2011). Unplanned readmissions after hospital discharge among patients identified as being at high risk for readmission using a validated predictive algorithm. Open Medicine, 5(2), e104–e111.Google Scholar
Hansen, L. O., Young, R. S., Hinami, K., Leung, A., & Williams, M. V. (2011). Interventions to reduce 30-day rehospitalization: A systematic review. Annals of Internal Medicine, 155(8), 520–528.Google Scholar
Hummel, P. (2013). Powerlessness. In Lubkin, I. M. & Larson, J. (Eds.), Chronic illness: Impact and intervention (pp. 315–337). Burlington, MA: Jones & Bartlett Learning.Google Scholar
Hunter, B., Neiger, B., & West, J. (2011). The importance of addressing social determinants of health at the local level: The case for social capital. Health and Social Care in the Community, 19(5), 522–530.Google Scholar
Hutchinson, S. L., & Wexler, B. (2007). Is “raging” good for health?: Older women’s participation in the raging grannies. Health Care for Women International, 28(1), 88–118.CrossRefGoogle Scholar
Lalonde, M. (1974). A new perspective of the health of Canadians: A working document. Retrieved fromhttp://www.hc-sc.gc.ca/hcs-sss/pubs/system-regime/1974-lalonde/index-eng.php.Google Scholar
Lattimer, C. (2011). When it comes to transitions in patient care, effective communication can make all the difference. Generations, 35(1), 69–72.Google Scholar
Livadiotakis, G., Gutman, G., & Hollander, M. (2008) Rationing home care resources: How discharged seniors cope. Home Health Care Services Quarterly, 22(2), 31–42.Google Scholar
Mahoney, J., Palta, M., Johnson, J., Jalaluddin, M., Gray, S., Park, S., et al. (2000). Temporal association between hospitalization and rate of falls after discharge. Archives of Internal Medicine, 160(18), 2788–2795.Google Scholar
Maramba, P., Richards, S., Myers, A., & Larrabee, J. (2004). Discharge planning process: Applying a model for evidence-based practice. Journal of Nursing Care Quality, 19(2), 123–129.Google Scholar
Marziali, E., McDonald, L., & Donahue, P. (2008). The role of coping humor in the physical and mental health of older adults. Aging & Mental Health, 12(6), 713–718.Google Scholar
McIntyre, L., & Tarasuk, V. (2002). Food security as a determinant of health. Paper presented at the Social Determinants of Health across the Life-Span Conference, Toronto, Ontario. Retrieved July 16, 2013, fromhttp://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf from http://www.phabc.org/modules/Food_Security/files/Food_security_as_a_determinant_of_health.pdf.Google Scholar
Mikkonen, J., & Raphael, D. (2010). Social Determinants of Health: The Canadian Facts. Retrieved fromhttp://www.thecanadianfacts.org/The_Canadian_Facts.pdf.Google Scholar
Molzahn, A. E. (2007). Spirituality in later life: Effect on quality of life. Journal of Gerontological Nursing, 33(1), 32–39.CrossRefGoogle ScholarPubMed
Mukotekwa, C., & Carson, E. (2007). Improving the discharge planning process: A systems study. Journal of Research in Nursing, 12(6), 666–686.Google Scholar
Nosbusch, J., Weiss, M., & Bobay, K. (2010). An integrated review of the literature on challenges confronting the acute care staff nurse in discharge planning. Journal of Clinical Nursing, 20, 754–774.Google Scholar
Raphael, D. (2009). Social determinants of health: An overview of key issues and themes. In Raphael, D. (Ed.), Social determinants of health (2nd ed.) (pp. 2–19). Toronto, ON: Canadian Scholars’ Press.Google Scholar
Raphael, D., Daiski, I., Pilkinton, B., Bryant, T., Dinca-Panatescu, M., & Dinca-Panatescu, S. (2011). A toxic combination of poor social policies and programmes, unfair economic arrangement and bad politics: The experience of poor Canadians with type 2 diabetes. Critical Public Health, 1(19), 1–19.Google Scholar
Stanhope, M., & Lancaster, J. (2012). Community health nursing in Canada. Toronto, ON: Elsevier Mosby.Google Scholar
Statistics Canada. (2006). A Portrait of seniors in Canada. Ottawa, ON: Statistics Canada. Retrieved July 16, 2013, from http://www.statcan.gc.ca/pub/89-519-x/89-519-x2006001-eng.pdf.Google Scholar