‘Patients come with two garbage bags full of problems and we have to sort them.’ <i>A qualitative study of the experiences of healthcare professionals on patients admitted to short-term residential care in the Netherlands</i>

Abstract

BACKGROUND: Short-term residential care (STRC) facilities were recently implemented in the Netherlands to provide temporary care to older adults with general health problems. The aim of STRC is to allow the individual to return home. However, 40% of patients are discharged to long-term care facilities. In-depth data about characteristics of patients admitted and challenges in providing STRC are missing. OBJECTIVE: To obtain perspectives of STRC professionals on the patient journey from admission to discharge. DESIGN: Qualitative study. SETTING: Eight nursing homes and three hospitals. SUBJECTS: A total of 28 healthcare professionals. METHODS: A total of 13 group interviews with in-depth reviews of 39 pseudonymised patient cases from admission to discharge. Interviews were analysed thematically. RESULTS: Many patients had complex problems that were underestimated at handover, making returning to home nearly impossible. The STRC eligibility criteria that patients have general health problems and can return home do not fit with current practice. This results in a mismatch between patient needs and the STRC that is provided. Therefore, planning care before and after discharge, such as advance care planning, social care and home adaptations, is important. CONCLUSIONS: STRC is used by patients with complex health problems and pre-existing functional decline. Evidence-based guidelines, appropriate staffing and resources should be provided to STRC facilities. We need to consider the environmental context of the patient and healthcare system to enable older adults to live independently at home for longer.