Dementia & Institutionalisation: Discharge from Hospital to Care Home

  • Research type

    Research Study

  • Full title

    Undiagnosed dementia and new institutionalisation: A study of 100 consecutive discharges from acute hospital to care home

  • IRAS ID

    166693

  • Contact name

    Juliet MacArthur

  • Contact email

    juliet.macarthur@nhslothian.scot.nhs.uk

  • Sponsor organisation

    Research and Development Department

  • Duration of Study in the UK

    0 years, 11 months, 27 days

  • Research summary

    This exploratory study aims firstly to examine the decision making processes involved in determining whether an older person leaving acute hospital care is discharged to a care home. Secondly, it aims to determine if undiagnosed dementia or other forms of cognitive impairment such as delirium might have influenced these processes. The following specific research questions will be addressed;
    1. What processes are involved in the discharge of an older person to care home?
    2. Does the patient have a formal diagnosis of dementia?
    3. If there is no diagnosis, is there evidence that they might have dementia?
    4. Was there evidence of delirium during the hospital stay?
    Case notes and electronic records of 100 retrospective consecutive discharges to care homes will be examined. NHS Information Identification of the sample will be through the patient management system TRAK utilising discharge destination codes. TRAK records of the patients and paper based case notes will be obtained and examined by a Research Assistant. Data will be extracted from the records using a standard protocol developed and piloted by the research team. All details will be anonymised. No patient identifiable information will be stored. Information such as age, gender, diagnoses, family support and social situation will be recorded along with information about the acute hospital admission. Length of admission, transfers, assessments, meetings and case conferences will be recorded and a timeline will be created to visually represent the progress through admission of each patient. The data will be analysed using a realist evaluation approach (Pawson & Tilley 2008). This will include analysis of the visual timelines to identify where structural and organisational factors impact the process of discharge.

    The study will provide insights into the decision making, diagnostic and evaluative processes contributing to a care home discharge. These findings will inform service development and future research projects.

  • REC name

    South East Scotland REC 01

  • REC reference

    14/SS/1092

  • Date of REC Opinion

    5 Dec 2014

  • REC opinion

    Favourable Opinion