Care Transitions in the Older Adult

Abstract

Abstract Introduction Transitions in care from the acute phase to other levels of care are an important aspect of discharge planning to facilitate adequate recovery and improve functional capacity especially in older adults. Inadequate discharge planning or discharge to an inappropriate or suboptimal care setting can lead to adverse events and avoidable rehospitalization. A good understanding of these care settings, eligibility, and financing options among medical students and residents is important in order to facilitate appropriate discharge plans and improve outcomes in older adults. Methods This interactive case-based learning activity requires approximately 45-60 minutes, but at our institution it is delivered in the context of a 4-hour workshop. The activity consists of nine patient vignettes that allow the learners to explore a variety of discharge settings and discuss appropriate sites of care, eligibility, and financing options. Results The evaluations indicate that this approach is well received by participants. Evaluations received from participants and assessments done using our internal ‘Basic In Geriatrics 10 test’ show that this session has been very useful in increasing the knowledge base of participants about sites of care for older adults and discharge planning. Discussion Proper care of our older adults is increasingly important as the U.S. population ages. We believe this learning activity can help prepare medical students to care for this vulnerable population.

Keywords

• Hospice
• Elderly
• Aging
• Discharge Planning
• Assisted Living Facility
• Independent Living