Assessing Family Caregiver Readiness for Hospital Discharge of Patients With Serious or Life-Limiting Illness Using Electronic Health Record (EHR) and Self-Reported Data.

Abstract

Objective: To assess how patient and caregiver factors influence caregiver readiness for hospital discharge in palliative care patients.

Study setting and design: This transitional care study uses cross-sectional data from a randomized controlled trial conducted from 2018 to 2023 testing an intervention for caregivers of hospitalized adult patients with a serious or life-limiting illness who received a palliative care consult prior to transitioning out of the hospital.

Data sources and analytical sample: Caregiver readiness was measured with the Family Readiness for Hospital Discharge Scale (n = 231). Caregiver demographic, intra- and interpersonal factors were self-reported. Patient demographic, comorbidity score, and risk score for complicated discharge planning were extracted from electronic health records. Stepwise regression models estimated variance explained (r²) in caregiver readiness for patient hospital discharge.

Principal findings: Patient demographics and complexity were not statistically associated with caregiver readiness for discharge. Caregiver depressive symptoms, poor caregiver-patient relationship quality, and fewer hours spent caregiving prior to hospitalization explained 29% of the variance in caregiver readiness.

Conclusions: Reliance on patient data may not be sufficient for explaining caregiver readiness for discharge. Assessing caregiver factors may be a better alternative for identifying caregivers at risk for low discharge readiness and those in need of additional support.

Trial registration: ClinicalTrials.gov on November 13, 2017, (No. NCT03339271).