Bridging the Gap: A Mixed Methods Study Investigating Caregiver Integration for People with Geriatric Syndrome

Isabelle Meulenbroeks; Liz Schroeder; Joanne Epp

doi:10.5334/ijic.5577

Figures & Tables

Table 1

Participant demographics.

CHARACTERISTIC	MEAN (RANGE)
Gender (number)
Female	10
Male	1
Age (years)	42 (31–51)
Years of experience	18 (4–30)
Number of previous workplaces	5 (2–10)
Number of current workplaces	1.36 (1–2)

Table 2

Barriers and facilitators to caregiver engagement in current practice.

	BARRIER OR NOT REQUIRED	FACILITATOR
Patient	Healthy straight forward patient	Poor cognition Requires high level care Actively asks for caregivers to be involved Non-English-speaking background
Caregiver	Perceived as unrealistic by staff Older carers/spouse	Proactive Pleasant Present on the ward Culture of family caregiving
Physiotherapist	Does not feel including caregivers is worthwhile Assumes another staff member will include caregiver Differing reactions to difficult situations Time management Untrained Short shifts/part-time employment	Listening Empathy Experience Communication skills Teamwork Good documentation Contextual knowledge e.g. services
Multidisciplinary team	Personal tensions within the team Poor communication Overlapping roles Overly siloed roles Language used to describe the caregiver and patient	Teamwork Communication Strong leadership Support/comradery in the team Good documentation
Facility	Physical environment Ambiguous visitor policy Healthcare as a business Electronic medical record system design Unclear privacy policy	Structured communication for within the team Structured communication between caregivers and Communication on patient whiteboards Quick involvement of appropriate disciplines
Healthcare system	Incentivises numbers of patients treated Resource poor Work not suited to casual/part time work force Poor integration between hospital and community Hospitals staffed hours Time constraints Delayed discharges	Perception of sufficient transitional/community services Flexible working arrangements for caregivers

Table 3

Interview schedule questions.

QUESTIONS
1.	What is your experience of engaging informal caregivers in transitions of care?
2.	What is an example/s of a positive experience you had whilst including caregivers?
3.	What is an example/s of a negative experience you had whilst including informal caregivers?
4.	Do you feel that the physiotherapists should be including informal caregivers in discharge planning/transitions of care?
5.	In ideal practice	Do supports need to be established for successful discharge planning?
		Should informal carers be included at patient admission/preadmission?
		Should discharge planning take place during the inpatient stay?
		What actions or steps do you think are necessary for a well performed patient discharge when patients are ready to leave the facility?
		Should informal caregivers be involved in organising patient follow-up or treatment plan?
Do you have any final comments or thoughts about what we have discussed?

Table 4

Coding structure.

Inconsistent caregiver engagement	Caregiver characteristics Patient characteristics Physiotherapist characteristics How the relationship between caregiver and healthcare professional forms Relationship with caregiver Social complexity
Individuals working in a complex system	Caregivers as a resource Physiotherapists perception of factors outside of their control The multidisciplinary team The hospital The healthcare system Leadership in discharge planning in the multidisciplinary team Uncertainty
Outdated model of care	Caregivers as coordinators of care Communication with caregivers Focus on care in hospital How healthcare professionals are affected by caregiver integration How caregivers are included in current practice by physiotherapists Caregiver engagement/disengagement affects the patient Perceptions of care Professionals as custodians of care
No solutions exist for invisible care gaps	Invisible problem Realisation of gaps Discharge planning involving caregivers in an ideal world What should caregiver engagement look like in an ideal world? When should caregivers be included? Flexibility Caregiver integration is necessary in a stressed system Lessons learnt from current practice Opinions on caregiver engagement Solutions perceived by physiotherapists

Bridging the Gap: A Mixed Methods Study Investigating Caregiver Integration for People with Geriatric Syndrome

Figures & Tables

Table 1

Table 2

Table 3

Table 4

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