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Potentially preventable hospitalizations in dementia: family caregiver experiences

Published online by Cambridge University Press:  28 March 2017

Tatiana Sadak ,
Susan Foster Zdon ,
Emily Ishado ,
Oleg Zaslavsky  and
Soo Borson
Tatiana Sadak*
Affiliation:
Geriatric Mental Health, Department of Psychosocial and Community Health, University of Washington School of Nursing, Seattle, WA, USA; Geropsychiatric Nurse Practitioner, Dementia Specialist, Psychiatric Wellness & Dementia Care, Seattle, WA, USA
Susan Foster Zdon
Affiliation:
University of Washington Medical Center, Emergency Department, Seattle, WA, USA
Emily Ishado
Affiliation:
Department of Psychosocial and Community Health, University of Washington School of Nursing, Seattle, WA, USA; Geriatric Medical Social Worker. Kline Galland Community Based Services, Seattle, WA, USA
Oleg Zaslavsky
Affiliation:
Department of Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Seattle, WA, USA
Soo Borson
Affiliation:
University of Washington School of Medicine and Affiliate Professor, University of Washington School of Nursing, Seattle, WA, USA; Adjunct Professor of Neurology and Nursing, University of Minnesota, Minnesota, MN, USA
*
Correspondence should be addressed to: Tatiana Sadak, PhD, PMHNP Assistant Professor of Geriatric Mental Health, Department of Psychosocial and Community Health, Department of Psychosocial & Community Health, School of Nursing, Campus Mailbox 357263, 1959 NE Pacific Street, Seattle, WA 98195, USA. Phone: # (206) 459-1158; Fax # (888) 296-8140. Email: sadakt@uw.edu. Mailing address: 22608 57th Ave W, Mountlake Terrace, WA 98043.
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Abstract

Background:

Health crises in persons living with dementia challenge their caregivers to make pivotal decisions, often under pressure, and to act in new ways on behalf of their care recipient. Disruption of everyday routines and heightened stress are familiar consequences of these events. Hospitalization for acute illness or injury is a familiar health crisis in dementia. The focus of this study is to describe the lived experience of dementia family caregivers whose care recipients had a recent unplanned admission, and to identify potential opportunities for developing preventive interventions.

Methods:

Family caregivers (n = 20) of people with dementia who experienced a recent hospitalization due to an ambulatory care sensitive condition or fall-related injury completed phone interviews. Interviews used semi-structured protocols to elicit caregivers’ reactions to the hospitalization and recollections of the events leading up to it.

Results:

Analysis of interview data identified four major themes: (1) caregiver is uncertain how to interpret and act on the change; (2) caregiver is unable to provide necessary care; (3) caregiver experiences a personal crisis in response to the patient's health event; (4) mitigating factors may prevent caregiver crises.

Conclusions:

This study identifies a need for clinicians and family caregivers to work together to avoid health crises of both caregivers and people with dementia and to enable caregivers to manage the health of their care recipients without sacrificing their own health and wellness.

Keywords

carersadverse eventsprimary carefalls
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 7 , July 2017 , pp. 1201 - 1211
Copyright
Copyright © International Psychogeriatric Association 2017 

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