Browsing by Subject "Skilled nursing facility"

Now showing 1 - 3 of 3
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    Complex Transitions from Skilled Nursing Facility to Home: Patient and Caregiver Perspectives
    (Springer, 2021) Carnahan, Jennifer L.; Inger, Lev; Rawl, Susan M.; Iloabuchi, Tochukwu C.; Clark, Daniel O.; Callahan, Christopher M.; Torke, Alexia M.; Medicine, School of Medicine
    Background: Patients who undergo the complex series of transitions from the hospital to a skilled nursing facility (SNF) back to home represent a unique patient population with multiple comorbidities and impaired functional abilities. The needs and outcomes of patients who are discharged from the hospital to SNF before returning home are understudied in care transitions scholarship. Objective: To study the patient and caregiver challenges and perspectives on transitions from the hospital to the SNF and back to home. Design: Between 48 h and 1 week after discharge from the SNF, semi-structured interviews were performed with a convenience sample of patients and caregivers in their homes. Within 1 to 2 weeks after the baseline interview, follow-up interviews were performed over the phone. Participants: A total of 39 interviewees comprised older adults undergoing the series of transitions from hospital to skilled nursing facility to home and their informal caregivers. Main measures: A constructionist, grounded-theory approach was used to code the interviews, identify major themes and subthemes, and develop a theoretical model explaining the outcomes of the SNF to home transition. Key results: The mean age of the patients was 76.6 years and 64.8 years for the caregivers. Four major themes were identified: comforts of home, information needs, post-SNF care, and independence. Patients noted an extended time away from home and were motivated to return to and remain in the home. Information needs were variably met and affected post-SNF care, including medication management, appointments, and therapy gains and setbacks. Interviewees identified independent function at home as the most important outcome of the transition home. Conclusions: Post-SNF in home support is needed rapidly after discharge from the SNF to prevent adverse outcomes. In-home support needs to be highly individualized based on a patient's and caregiver's unique situation and needs.
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    Transitions From Skilled Nursing Facility to Home: The Relationship of Early Outpatient Care to Hospital Readmission
    (Elsevier, 2017-10-01) Carnahan, Jennifer L.; Slaven, James E.; Callahan, Christopher M.; Tu, Wanzhu; Torke, Alexia M.; Medicine, School of Medicine
    BACKGROUND: Many adults are discharged to skilled nursing facilities (SNFs) prior to returning home from the hospital. Patient characteristics and factors that can help to prevent postdischarge adverse outcomes are poorly understood. OBJECTIVE: To identify whether early post-SNF discharge care reduces likelihood of 30-day hospital readmissions. DESIGN: Secondary data analysis using the Electronic Medical Record, Medicare, Medicaid and the Minimum Data Set. PARTICIPANTS/SETTING: Older (age > 65 years), community-dwelling adults admitted to a safety net hospital in the Midwest for 3 or more nights and discharged home after an SNF stay (n = 1543). MEASUREMENTS: The primary outcome was hospital readmission within 30 days of SNF discharge. The primary independent variables were either a home health visit or an outpatient provider visit within a week of SNF discharge. RESULTS: Out of 8754 community-dwelling, hospitalized older adults, 3025 (34.6%) were discharged to an SNF, of whom 1543 (51.0%) returned home. Among the SNF to home group, a home health visit within a week of SNF discharge was associated with reduced hazard of 30-day hospital readmission [adjusted hazard ratio (aHR) 0.61, P < .001] but outpatient provider visits were not associated with reduced risk of hospital readmission (aHR = 0.67, P = .821). CONCLUSION: For patients discharged from an SNF to home, the finding that a home health visit within a week of discharge is associated with reduced hazard of 30-day hospital readmissions suggests a potential avenue for intervention.
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    We Are All In This Together: Research analysis of social isolation and art therapy within retirement communities
    (2016) Williamson, Courtney; King, Juliet
    This research study investigated social isolation within a skilled nursing facility. It was hypothesized that through the participation in a 6-week art therapy group, residents living in a Midwest skilled nursing facility would display a decrease in social isolation. The mixed methods design implored a survey for staff members to establish the facility's understanding of social isolation and a 6-week art therapy group in which five residents participated. The participants were interviewed utilizing a pre and post-test based on a questionnaire from the National Social Life, Health, and Aging Project (NSHAP) to measure their social isolation. Following the survey, participants' pre and post-test results were averaged to find statistical significance to determine the level of interpersonal interactions within each group session. Twelve questions measuring social isolation were shown to have positively increased, including social network range, ability to open up and trust friends and family, and the amount of weekly-attended activities. Two questions showed a negative increase in social isolation and the remaining questions did not show a statistical difference. Verbalizations and artwork within the art therapy groups were consistent with these positive increases. These results can further promote art therapy as a cost effective tool, which can provide a long-term collective approach aimed at proactive aging care as opposed to a short-term reactive approach. Future implications of this study include exploring correlations between the art therapy interventions and indicators for social isolation. Increasing the time spent in might also yield a more generalizable pre and post-test response pattern.