An Exploration of Carers of Stroke-Survivors in Ireland Experiences of the Discharge Planning Process and Transition of Care to the Home Setting

2020-07-24T11:55:38Z (GMT) by Shelagh O'Connor
Introduction
In Ireland, it is estimated that 10,000 people have a stroke annually. A high number
of stroke-survivors with residual deficits requiring care are discharged to their own.
Informal carers are often central in homecare provision. The discharge planning
process (DPP) is the process used to establish the requirements necessary for a
patient to transition from one level of care to another, and may involve carers.

Aims and Objectives
The aim of this study was to explore the experiences of carers of stroke-survivors in
Ireland, in relation to the DPP and transition of care to the home setting. The
objectives were; to identify carers’ perceptions of being engaged in necessary
discussions when discharge-planning. To identify experiences of the DPP that
affected planning for and impacted upon effective transition to the home setting,
including perceived supports and barriers. To explore the impact of onward referral,
and access to support services, on the DPP and transition of care to the home setting.

Methods
This study employed a qualitative descriptive design using semi-structured
interviews, with carers of stroke-survivors in Ireland (n=6). The Caregiver Burden
Scale (CBS) was used a thematic prompt by participants prior to conducting
interviews. Key themes emerged from data analysis, which were identified using
thematic analysis.

Results
Results of the CBS (Macera et al., 1993) identified areas where participants provided
care and areas that increased their stress. Theme one involved preparation for
discharge while in the hospital. Supports at this time, included access to an
information-pack on aspects related to their relative’s care. Theme two related to
access to community-services and life at home post-discharge, with access to early
supported discharge described as beneficial.

Conclusions
Effective communication of information, provision of necessary training and access
to community services upon discharge, were considered key components of effective
discharge planning.

Implications of Findings
Health professionals must ensure that adequate information exchange and training
occurs with carers of stroke-survivors, to support their involvement in the DPP and
ensure continuity of care on discharge.