Older adults with complex care needs’ experiences within a hospital-to-home transition patient navigator program: A qualitative descriptive study

Abstract

Introduction Older adults living with complex care needs are often hospitalized due to poor community support. Recommendations for improving patient and family experiences include having a patient navigator to support patients and caregivers in hospital and community settings. This study aimed to report on older adults’ and caregivers’ experiences of receiving services from a hospital-to-home patient navigation program. Methods A qualitative descriptive study was conducted. Telephone interviews were conducted with 14 older adults with complex care needs or their family caregivers in Toronto, Ontario from 2020 to 2021. Data were analyzed using inductive thematic analysis. Results Four themes were identified: (1) Initial Hesitancy; (2) Meeting Evolving Needs; (3) Unexpected Benefits of Patient Navigation; and (4) The Value of Patient Navigation in Sustaining Aging-in-Place. Participants viewed all their interactions with the navigator as positive, and perceived navigators improved their quality of care. Discussion These study findings suggest that patient navigators may be well-positioned to address gaps in services around psychosocial support and care coordination while also encouraging self-management in older adults with complex care needs.