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Follow-up visits to older patients after a hospital stay: nurses' perspectives

02 February 2019
Volume 24 · Issue 2


Older patients with multimorbidity and extensive healthcare needs are at risk of frequent readmission to hospital after discharge. With a Swedish report entitled ‘Follow-up 48–72’ as its basis, the present study aimed to describe nurses' experiences of follow-up visits to older patients with multimorbidity 48 to 72 hours after discharge from hospital. Semi-structured interviews were conducted with 10 nurses experienced with such home visits to older patients, and the material was analysed by qualitative content analysis. The results indicate that such visits by nurses can relieve patient anxiety, as patients are often unsure of the next steps, in terms of medication and care. According to the nurses, these visits created trust in the nurse–patient relationship and ensured patient safety. Follow-up visits soon after discharge from hospital should become a part of routine nursing, especially for older people with multimorbidity.

The number of older people with multimorbidity and disabilities is increasing worldwide, and because of their extensive care needs, these individuals are at risk of frequent hospitalisation (World Health Organization (WHO), 2016). From the health and welfare perspective, multimorbidity in older persons encompasses a number of health problems and an overall need of care. In addition to diseases, multimorbidity includes physical and cognitive dysfunction, sleep disorders, pain and sensory difficulties (Statens Offentliga Utredningar, 2010). According to WHO, a disease-oriented approach is no longer appropriate in home care. Home care in Europe will need to be changed to reflect the increasing number of care-dependent older people and noncommunicable diseases. Changes in patient needs and social structure require a different approach from the health and social sectors (WHO, 2018). Genet et al (2011) showed how the development of home care policies differs among European countries but identified four domains that constitute the key aspects of home care systems: policy and regulation, regulation of quality, financing and organisation, and service delivery.

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