Michelle Nelson, PhD is a Research Scientist within the Lunenfeld-Tanenbaum Research Institute in Toronto, Canada. She is an Assistant Professor (status) in the Institute of Health Policy, Management and Evaluation at the University of Toronto. Her research is concentrated on the organization and delivery of health care services for patients with multiple intersecting health and social concerns, examining topics related to clinical management of uncertainty, collaborative practice, integrated care, health profession education, within the context of rehabilitation and community reintegration.
Volunteer Supported Hospital Discharge: A Strategy to Address Instrumental Activities of Daily Living and Social Isolation
Background: Patients with ‘complex care needs’, particularly older adults, experience heightened vulnerability at the time of discharge from hospital. These patients are often in need of services that address both health and social issues when they leave the hospital, which can complicate the transition process – adversely affecting physical recovery, mood, social participation, quality of life and ultimately, self-management and self-care capacity of patients and their families. Issues of isolation and vulnerability are pervasive among older adults transitioning from the hospital to home and that there is corresponding demand for transition services. The voluntary sector is an important partner in supporting older adults’ in the community.
Methods: We sought to explore the specific elements of volunteer supported patient care transition programs, and how these programs support patients re-integrate into the community and live independently. Using a comparative research design and qualitative descriptive analysis, five community re-integration and hospital to home transition programs across England and Canada were examined. Interviews were conducted with a total of fifty-one participants, comprised of eleven focus groups with volunteers and program coordinators, and seventeen individual interviews with patients.
Results: A small number of volunteers in each program supported a large number of older adults over the age of 65 by providing support for instrumental activities of daily living (e.g. shopping, light housework, transport, collecting prescriptions). Volunteers also provided social and emotional support (e.g. befriending, peer support, community navigation, caregiver support), reducing loneliness and fostering increased confidence levels. Evaluations of programs showed service users had decreased admissions to emergency rooms post discharge compared to population data, as well as reported increased quality of life, and decreased social isolation.
Conclusion: Voluntary sector programs can serve as a ‘safety net’ for patients at time of hospital discharge and promote independent living. Volunteers provide unique contributions in improving health and social care integration, particularly in transitional care. Skilled volunteers that are adaptable, flexible, and have good interpersonal skills can have a positive impact on older adults’ experiences returning home and their communities.