Discharge care transitions for patients with dementia: a qualitative study of Hispanic patients' and families' experiences in the ED.
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Project Abstract: The older adult population in the United States is becoming increasingly diverse, more are seeking ED- based care, detection and documentation of dementia is improving, and informal family caregivers are playing a greater role in navigating the healthcare system, particularly within minoritized populations. Due to these changes, it is therefore critical to identify the unique challenges minoritized patients with dementia and their families experience during ED care transitions. Numerous studies have documented differences in dementia prevalence among racial and ethnic groups in the US and have found that Black and Hispanic/Latinx populations have a higher risk of dementia compared to White populations. Thus, it is critical to understand the perspectives of patients and their family members to gain a better understanding of the factors and relationships influencing ED discharge care transition experiences for underrepresented patients with dementia. This supplement seeks to fill a significant gap in the literature by exploring approaches to ED discharge care transition experiences for Hispanic patients with dementia. Using participant surveys and qualitative interviews, the supplement will be guided by the following aims: Research Aim 1: We will explore how Hispanic patients with dementia, and patient family members approach the ED discharge care decision process. Specifically, we seek to understand the facilitators and barriers for making patient goal-concordant care decisions. Research Aim 2: We will explore the perceived ED experiences of persons living with dementia and their family members after the patients have been discharged. Specifically, we will examine discharge pathways, perceived communication quality, and perceptions of ED environments. The study design will be a qualitative exploratory study. Eligible subjects will be recruited from the ED setting and include patients >65 age, with a documented dementia diagnosis, and discharged from the ED. Patients and dyads (patients and their identified care partner) will be consented and enrolled to complete an in-ED questionnaire and participate in a subsequent qualitative interview. Results will address gaps in understanding about emergency care transitions and communication and shared decision-making barriers for dementia patients seen in the ED that may be underserved and identify as Hispanic/Latino(a). The supplement will provide training opportunities and experiential research for Ms. Sandoval that will equip and position her well as a strong applicant to doctoral programs and future investigator.
