Gaps in U.S. health care limit options for older adults, expert says

"Coordination among families, patients and health care providers is essential to providing effective care for the aging population in the next few years," said Lori Popejoy, assistant professor in the MU Sinclair School of Nursing. "Stress, fear and lack of understanding often complicate the decision-making process for families and patients. Open communication is needed to support end-of-life care and decision making."

Hospital visits and discharge processes are often complicated; family members have to communicate with each other and health care team members (HCTMs), which include physicians, nurses and hospital staff, about treatments and make decisions with limited resources. Popejoy identified common concerns about the process: going home, advocating for independence, making decisions and changing plans.

"A new approach to the hospital discharge process should further consider the rights of patients and families -- to be fully and accurately informed of older adults' conditions and realistic care options, including home care, personal care and nursing homes," Popejoy said.

Popejoy says decision making should be an interactive and incremental process that occurs among patients, families and HCTMs. A HCTM can be designated to communicate information among care providers, patients and their families. In previous research, Popejoy found that families and patients who worked with a nurse communicator reported less stress and better overall care.