Introducing voluntary services during the discharge process of long-term hospitalised elderly patients.

Abstract

A remarkable Increase in long-term hospitalised elderly patients was noted at 'local general hospital. Elderly patients, mainly the 75+ years category, who need assistance are not finding adequate formal or informal support in the community and thus opting for institutional care. Waiting lists for institutionalisation are long with the consequence of prolonged hospitalisation. Repeatedly, long-term hospitalised elderly patients are being stereotyped as bed blockers or social cases. According to computer database of local general hospital, in March 2007, the number of patients was 49, of whom 42 were old elderly patients. This means that the impetus of the study is to centre on the older elderly age bracket (75+ years). Being a staff nurse by profession and working in the social policy field, the researcher linked long-term hospitalised elderly patients and the remarkable number of volunteers in Malta, thus investigating the managerial implications of a system that recruits, coordinates and links volunteers to long-term hospitalised elderly patients, whilst in the discharge process. Hospital volunteers are a social capital and are complimentary to hospital resources and cost-effective, however volunteers should not replace paid staff (Warner 1998). Therefore hospital volunteers could top up current gaps in service provision. Hospital volunteers could support long-term hospitalised elderly patients during the discharge process. This descriptive exploratory study explored the managerial implications of this volunteer-based system. A purpose sampling of 22 potential hospital volunteers and 20 local general hospital managers and related health care professionals was carried out. Three focus groups sessions were done with potential hospital volunteers and a Likert scale self-administered questionnaire was distributed to local general hospital managers and related health care professionals. The response rate for focus groups was 45.5% and 70% for the Likert scale questionnaire. Since both qualitative and quantitative research instruments had the same themes, the author could identify the main common managerial implications deriving from the target population. The findings included, acknowledging current long-term hospitalised elderly patients' poor quality of life, feel urgency to ameliorate situation, enhance consultations prior implementation of the system, scrutinise foreign volunteer-based systems in public hospitals, recognise value of hospital volunteers and how these could assist long-term hospitalised elderly in their activities of daily living. Nevertheless, a clear strategic framework is needed to minimise resistance to change, plan adequate financial resources and well-designed recruitment, training and induction programs. Continuous support is to be mandatory at any stage of the hospital volunteer experience, before starting and once work has commenced. A set of recommendations was addressed to local general hospital managers and to set-up a task force to analyse situation and study the link between hospital volunteers and long-term hospitalised elderly patients. Volunteers should be valued and recognised within the hospital's mission statement. Additionally the following were recommended: study the cost utility of a volunteer-based system at local general hospital, involve all stakeholders and minimise resistance to change, invest in a volunteer system that provides comprehensive recruitment methods, adequate training and induction programs, and provide the necessary framework and support. Hopefully this study increases awareness of local health and social care authorities to involve hospital volunteers and ameliorate quality of life of long-term hospitalised elderly, whilst in the discharge process. Nevertheless this research should serve as a model to plan volunteer-based systems across all local public hospitals.