Supporting Care Transitions for Older Adults with Multiple Long-term Conditions Including Dementia: The Digital Solution by Lauren Lawson

Supporting Care Transitions for Older Adults with Multiple Long-term Conditions Including Dementia: The Digital Solution, by Lauren Lawson

For my PhD within the Newcastle PSRC, I am investigating how we can use digital technologies to support older adults with multiple, complex health and social care needs, to ensure they remain safe as they move between different care environments.

The landscape of healthcare for older adults is evolving, and with it, the challenges of managing complex conditions like dementia. Characterised by a progressive impairment in cognition, symptoms of dementia can affect memory, problem-solving, language and behaviour, which worsens the ability to perform everyday activities over time. As the population ages, the number of older adults (aged 65 years and above) living with dementia is rising. However, dementia rarely travels alone. On average, older adults with dementia live with four additional long-term health conditions, resulting in complex care needs. Currently, our healthcare system uses a single-disease approach, focused on treating one condition at a time, which doesn’t adequately address the needs of those living with multiple health issues.

In order to access services to support and manage their care needs, older adults with multiple long-term conditions including dementia experience frequent transitions between healthcare settings, and between healthcare professionals. This includes transitions between hospital, home, and residential care, as well as receiving care from outpatient services.

What does this mean for patient safety?

Care transitions between several providers can further exacerbate the complexities of managing dementia alongside multiple long-term conditions. Suboptimal transitions of care, through multiple different services, can expose this group to lapses in patient safety which could include:

• Delays in receiving appropriate treatment and support due to breakdowns in communication,
• Test results being lost in the transfer of information between services,
• Preventable admissions and readmissions to hospital.

As well as the risk they present to patient safety, suboptimal care transitions can also impact well-being. Informal caregivers, often family members, or friends, play a pivotal role in supporting older adults with dementia with their care needs as the condition progresses. Combined with providing care to a loved one, having to navigate transitions through multiple health systems can contribute to increased stress, depression, and anxiety.

Going digital

Digital technologies have been widely advocated as an approach to support the way healthcare is delivered. Electronic health records, patient portals, and other digital tools offer the promise of enhanced communication and information sharing between healthcare providers, presenting a more patient-centred approach to care. By providing access to comprehensive health information and facilitating communication between care providers, digital solutions have the potential to mitigate the challenges associated with care transitions.

However, the success of using digital technologies hinges on whether they are suitable and inclusive. Digital solutions to support older adults with multiple long-term conditions including dementia to make safer, integrated transitions of care must be tailored to meet their specific care needs. Importantly, we must also ensure that they don’t exacerbate existing health inequalities, which is a key emphasis within the Newcastle PSRC. This is a crucial step towards creating a healthcare system that truly works for everyone.

So, what are we going to do?

Through my PhD, I am investigating how digital solutions can be used to support transitions from hospital to home for older adults with multiple long-term conditions including dementia. This work is aligned with the Newcastle PSRC’s theme ‘Safer integrated health and social care environments,’ which aims to understand how we can safely transfer care from one provider to another.

By exploring how digital solutions can be used to facilitate integrated transitions of care, this work aims to understand what needs to be done to support older adults with multiple long-term conditions including dementia to manage their complex healthcare needs.