Authors: (including presenting author): :
Ma KW, Kaur S, Jong CW, Cheng HC, Tang SW
Affiliation: :
Medicine and Rehabilitation department, Tung Wah Eastern Hospital
Introduction: :
2016 Hong Kong census thematic report reflected a total of 1,163,153 elderly individuals, who accounted for 46% of hospital admission. During hospitalisation, the elderly may experience cognitive decline, physical decline, lingering stress and loss of power. These deconditioning statuses are due to unfamiliar environment and faces, a massive change in living routines and disease condition. Involving the family in patient care can help ease the experience of hospitalisation and reduce the potential complications for elderly patients. Thus, we invited family members or carers to participate as care partner in the daily patient care to improve care quality.
Objectives: :
1. To build and maintain a therapeutic relationship with patient and their family.
2. To embed patient’s lifestyle and habit in caring procedures during hospitalisation.
3. To engage families or carers in daily caring activities.
4. To improve quality of care and prevent potential complications for elderly patients.
5. To enhance the carers’ knowledge and skills on elderly care.
6. To facilitate the continuity of patient care.
Methodology: :
Suitable patients and carers were identified to participate in the programme. Then, a care plan was formulated together with patients and carers. Afterwards, carer training was carried out according to their care needs. After training, a carer passport was issued to the carer to signify completion of training and qualification of caring in the trained aspects. Carer’s knowledge and skills on patient turning, oral care, feeding care, urinary catheter care and nasogastric tube feeding were assessed. Additionally, patients’ development of potential complications was reviewed upon discharge. Finally, the staff and patients’ satisfaction survey was conducted.
Result & Outcome: :
A total of 21 pairs of elderly patients and carers were recruited during 9/2019 to 3/2020 in the orthopaedics and stroke rehabilitation wards of Tung Wah Eastern Hospital. 15 pairs of patients and carers were from orthopaedics, and 6 pairs were from stroke ward. Carers were trained in different aspects, oral feeding (13), nasogastric tube feeding (11), oral care (18), position turning (11) and urinary catheter care (12). Average length of stay was 16 days which was shorter than 22 days and 21 days for general orthopaedics and stroke patients, respectively. No complications on various aspects occurred, including fall incidents, urinary tract infections, new developed pressure sores and aspiration pneumonia. Duration of physical restraint applications were minimised as no restraints were required under the company of carers. Carer survey showed that all carers agreed that involving carers in patient care during hospitalisation had a positive effect. All carers expressed that the carer education provided by nurses was very helpful in caring for their loved ones. Staff survey showed that carers were welcome to participate in patient caring activities and doing so could ease part of their workload. In conclusion, carers’ involvement in patient care at the hospital was a triple-win situation; it improved care outcomes, enhanced carers’ confidence and eased the workload of nurses. This programme improves the quality of patient care as well as facilitates continuity of care for the elderly patients after discharge from hospital. Therefore, promoting this programme as part of future care training is worthwhile.
