Requirements for promoting the transition of aging patients with cognitive and physical disorders to home care: A new case analysis design

Abstract

Objective: This study clarified requirements for transitioning aging patients with cognitive and physical disorders to home care and developed a new mixed methodology using medical records.
Background: Japan has the highest proportion and highest rate of increase of older adults worldwide. Transitioning aging patients from hospital to home care is a key strategy to manage this increase; however, this transition presents challenges.
Methods: A mixed method study was conducted, using descriptive data from medical records.
Results: Of 41 participants, 61% were amicable settlement cases and 39% were non-amicable. In total, 56.1% went home: 36.6% were amicable and 19.5% were non-amicable. Requirements for transition to home care were [Patient’s mental stability], [Necessary care for the patient within the family’s tolerance level], [Decreasing the family’s burden of care by accessing the public care service], [Preparing the family to bear the heavy burden of caring for multiple family members at home], [Decreasing the risk of worsening condition through patient compliance], and [Setting realistic goals and reconciling them with the family].
Conclusions: The transition requirements related to cognitive disorders, gaps in physical functioning before and after hospitalization, and aging society. They were fulfilled through concrete preparation of the family for coping with home care, with the patient’s mental stability as a precondition.
Relevance to clinical practice: Fulfillment of these requirements is essential for successful transition to home care for aging persons with multiple disorders. Our original mixed method design promotes a new methodology for qualitative research using descriptive data from medical records.