Factors associated with family caregiver dissatisfaction with acute hospital care of older cognitively impaired relatives

Whittamore, Katherine H. and Goldberg, Sarah E. and Bradshaw, Lucy E. and Harwood, Rowan H. (2014) Factors associated with family caregiver dissatisfaction with acute hospital care of older cognitively impaired relatives. Journal of the American Geriatrics Society, 62 (12). pp. 2252-2260. ISSN 1532-5415

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Abstract

Objectives

To identify patient and caregiver characteristics associated with caregiver dissatisfaction with hospital care of cognitively impaired elderly adults.

Design

Secondary analysis of data from a randomized controlled trial.

Setting

An 1,800-bed general hospital in England providing the only emergency medical services in its area.

Participants

Cognitively impaired individuals aged 65 and older randomly assigned to a specialist unit or standard geriatric or internal medical wards (N = 600) and related caregivers (N = 488).

Measurements

Patient and caregiver health status was measured at baseline, including delirium, cognitive impairment, behavioral and psychological symptoms, activities of daily living, and caregiver strain. Caregiver satisfaction with quality of care was ascertained after hospital discharge or death.

Results

Four hundred sixty-two caregivers completed satisfaction questionnaires. Regardless of assignment, 54% of caregivers were dissatisfied with some aspects of care, but overall 87% were satisfied with care. The main areas of dissatisfaction were communication, discharge planning, and medical management. Dissatisfaction was associated with high levels of patient behavioral and psychological symptoms on admission, caregiver strain and poor psychological well-being at admission, a diagnosis of delirium, and the relationship between the caregiver and the patient. There was less dissatisfaction from caregivers of patients managed on the specialist Medical and Mental Health Unit than those on standard wards, after controlling for multiple factors.

Conclusion

Dissatisfaction was associated with patient behavioral and psychological symptoms and caregiver strain but was not immutable to efforts to improve care.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: J Am Geriatr Soc 62:2252–2260, 2014, which has been published in final form at http://dx.doi.org/10.1111/jgs.13147. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: aged; general hospitals; satisfaction; dementia; delirium; caregivers
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Epidemiology and Public Health
University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rehabilitation and Ageing
Identification Number: https://doi.org/10.1111/jgs.13147
Depositing User: Goldberg, Sarah
Date Deposited: 01 Aug 2016 08:22
Last Modified: 16 Sep 2016 05:02
URI: http://eprints.nottingham.ac.uk/id/eprint/35536

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