Abstract
Background
Transitioning from hospital to home is not just a process but a crucial aspect of healthcare delivery, particularly for older adults and their informal caregivers. This transition from the structured environment of the hospital to the more independent home setting presents various challenges and opportunities that significantly impact the post-discharge journey and remains a critical and vulnerable phase for patients, especially those with complex medical needs or limited support systems. With a rapidly aging population, diverse cultural demographics, and a centralized healthcare system, Israel provides a multifaceted context to explore the intricacies of this transition process. This paper explores the experiences of older adults and informal caregivers navigating hospital-to-home care transitions in Israel and the challenges and opportunities in optimizing care transitions.
Methods
Conducted within the European TRANS-SENIOR consortium, we conducted a qualitative descriptive study using one-to-one interviews with Israeli older adults and informal caregivers. who experienced hospital-to-home transitions within the past 12 months. Interview questions explored negative and positive experiences navigating hospital-to-home transitions and challenges and opportunities for optimizing care transitions. Thematic analysis was used.
Results
Seven older adults and nine informal caregivers participated in interviews, revealing diverse perceptions of hospital-to-home transitions. The experiences of hospital-to-home transitions varied, with negative experiences characterized by abrupt farewells and a perceived lack of ongoing support, while positive experiences involved reassurance, empowerment, and follow-up care. Challenges included fragmented healthcare management and a lack of person-centered care, particularly for older adults without family support or facing critical conditions, Additional issues included bureaucratic hurdles, language barriers, and communication deficiencies. Opportunities for improvement in Israel's care transition system for older adults and informal caregivers include promoting individual autonomy, involvement in decision-making, and enhancing collaboration between hospitals and communities.
Conclusion
Challenges across the care continuum highlighted the need for targeted interventions to address communication, person-centered care, and continuity of care. Policymakers can use this information to develop and implement strategies to improve the transition process, ultimately leading to better patient outcomes and experiences.