Informal caregivers are instrumental in supporting the activities of older adults; however, caregiving can negatively impact caregivers’ health. This qualitative study explored the experiences, support, and unmet needs of informal caregivers of older adults (n = 12) in Rhode Island. Interviews were audio recorded, transcribed and analyzed through a thematic analysis approach. Identified themes were categorized into three domains: 1) Health Services Challenges for Care Recipients, 2) Negative Impact on Caregivers, and 3) Caregiver Coping Strategies and Challenges. Results indicate that informal caregivers often struggled to access health services and experienced significant disruptions in their lives, ultimately taking a toll on their health and well-being. Finding meaning through caregiving for loved ones and home self-care practices, such as yoga, helped caregivers cope with personal challenges. Findings suggest the need for tailored interventions to better support caregivers throughout the caregiving process.
Introduction Older adults with frailty presenting to the emergency department (ED) have worse short- and long-term outcomes than those who are not frail. Frailty screenings are often applied retrospectively to demonstrate a relationship between frailty and outcomes; it is not known whether frailty screening can inform decision-making about acuity at triage or ED disposition. Purpose To determine whether the use of frailty screening at triage or during an ED stay can inform triage acuity or provide information to inform disposition decisions. Methods Covidence software was used to identify primary studies conducted from 2000-present with a patient population of greater than 65 years of age, presenting to the ED, which described using a frailty tool to inform clinical decision-making. Exclusion criteria comprised case reports, systematic reviews, conference abstracts, non-ED settings, written in a language other than English, or in which frailty was used as a covariant rather than a predictor.The search yielded 6360 studies for screening. 2042 duplicates were identified and removed. Of the 4318 remaining abstracts screened, 93 full-text studies met initial criteria and were assessed for eligibility, and 88 of them were excluded. Five studies were evaluated for this review. Results Early identification of frailty at triage facilitates intervention by case management or geriatric-specific care teams which can reduce ED under-triage, ED revisits, and re-admission in patients greater than 65 years of age who screen positive for frailty. Conclusions Frailty screening processes can and should be used to identify older patients who may be more acutely ill than they initially appear at presentation, or may require more consideration at the point of discharge decision-making and may benefit from medical or case management interventions in the ED.
