Gustavson Allison M, Hudson Emily M, Wisdom Jennifer P, Woodward-Abel Alicia B, Hoffman Rashelle, Miller Matthew J, Fink Howard A, Gaugler Joseph E, Hagedorn Hildi J
Veterans Affairs Health Services Research and Development, Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA; Veterans Affairs Rehabilitation Research and Development Center for Rehabilitation and Engineering Center for Optimizing Veteran Engagement and Reintegration, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Veterans Affairs Health Services Research and Development, Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.
J Am Med Dir Assoc. 2025 May;26(5):105534. doi: 10.1016/j.jamda.2025.105534. Epub 2025 Mar 20.
Persons with dementia are frequently hospitalized, which threatens their ability to return to and live at home. Current post-acute paradigms tend to default to short-term rehabilitation in a nursing home. Still, alternative post-acute care models are crucial for veterans with dementia to recover at home. This study aims to identify the needs of veterans with dementia, care partners, and rehabilitation clinicians in relation to home-based models of care to inform the implementation and adaptation of models to the post-acute context.
Qualitative study.
Participants included veterans with dementia with recent history of hospitalization, care partners, and rehabilitation clinicians.
Semi-structured interviews were conducted across 3 groups (veterans with dementia, care partners, and rehabilitation clinicians) and analyzed using a rapid qualitative approach guided by the Practical, Robust Implementation and Sustainability Model (PRISM).
Participants included 11 veterans with dementia, 13 care partners, and 23 rehabilitation clinicians. We identified 3 themes from the interviews: (1) collaborative decision making and planning are crucial to high-quality care, (2) follow-through is necessary to ensure needs are met when transitioning from hospital to home, and (3) alternative care options, including technology use, are important when optimizing transitions of care.
Alternative options for home care after hospital discharge may enhance patient-and family-centered outcomes. Future research must identify evidence-based models that can be collaboratively adapted or developed to provide effective, safe, and feasible post-acute care to optimize independence in the home and quality of life.
痴呆症患者经常住院，这威胁到他们回家并在家中生活的能力。当前的急性后期模式往往默认在疗养院进行短期康复。尽管如此，替代的急性后期护理模式对于患有痴呆症的退伍军人在家中康复至关重要。本研究旨在确定患有痴呆症的退伍军人、护理伙伴和康复临床医生在家庭护理模式方面的需求，以为将这些模式实施和调整到急性后期背景提供信息。
定性研究。
参与者包括近期有住院史的痴呆症退伍军人、护理伙伴和康复临床医生。
对三组人员（患有痴呆症的退伍军人、护理伙伴和康复临床医生）进行了半结构化访谈，并使用由实用、稳健实施和可持续性模型（PRISM）指导的快速定性方法进行分析。
参与者包括11名患有痴呆症的退伍军人、13名护理伙伴和23名康复临床医生。我们从访谈中确定了3个主题：（1）共同决策和规划对于高质量护理至关重要；（2）在从医院过渡到家庭时，跟进措施对于确保需求得到满足是必要的；（3）在优化护理过渡时，包括技术使用在内的替代护理选择很重要。
出院后家庭护理的替代选择可能会改善以患者和家庭为中心的结果。未来的研究必须确定基于证据的模式，这些模式可以共同调整或开发，以提供有效、安全和可行的急性后期护理，以优化在家中的独立性和生活质量。
