Heart Failure Readmission Among Older Adults
Heart failure (HF) is an ailment in which the human heart is not capable to pump an adequate amount of blood to meet one’s body demands. Several studies have been conducted on different aspects of readmission in hospitals among older adults, HF is counted as one of them. However, comparable results are advocated in this research because most facets of HF readmission are being investigated, for example, HF home management, medication adherence, quality of life (QOL). Sevilla-Cazes et al., (2018) suggest that recognizing client and caregiver challenges managing HF at home, and the patient’s apparent explanations for readmission, while other researches recommend the same. To comprehend the causes of HF readmission in hospitals among older adults, all aspects should be studied. This paper investigates Sevilla-Cazes et al., (2018) research compared with other HF readmission research to suggest that further research should be performed to better understand what leads to hospital readmission related to HF among older adults. For this purpose, the literature is classified under three sections: (1) Improve patient education at discharge, (2) Arrange follow-up appointments, and (3) execute home health care plans.
An observational qualitative study conducted by Sevilla-Cazes et al., (2018) review open-ended, semi-structured interviews, to discover a blend of socio-emotional and physical impacts on patient’s HF management at home. Two of the three reviewed studies focusing on patients’ feelings, by face-to-face interaction between the caregiver and the patient (Sevilla-Cazes et al., 2018). In another cross-sectional study, conducted by Turrise, (2016) CareNavRN intervention was introduced to review research of HF home management amid older adults transitioning home. Likewise, Turrise, (2016) noted that clients receive instructions and additional instruction about HF home management by the nurse, along with guidelines about four home visits. Van Spall et al. (as cited in Turrise, 2016) noted that the very prime factor about home management of HF is confrontational interaction between the health care provider and patient. However, in telephonic questionnaire surveys, participants responded feeling more distant, less adherent to the medication regimen, and home management of HF (Turrise, 2016).
Knowledge about HF medication and adherence to it, as managing medication regimen at home plays a major role among older adults. In Leavitt, Hain, Keller, & Newman, (2020) the recent findings suggest that in the intervention group there is drastic progress about the medication with time-related to HF knowledge, as compared to the control group. Not having proper information about the medication regimen continues to be an issue in many HF hospitalized patients (Leavitt et al., 2020). Similarly, Sevilla-Cazes et al., (2018), analyze that providing palliative care, like psychological, spiritual, support with treatment, information about medication might boost HF management during discharge. In support of the findings, Turrise, (2016) noted that the patients have no personal control over their illness and believed that, it relates significantly to medication adherence. Also, Carels (as cited in Park, Brooks, & Sussman, 2009) found that the seriousness of HF was also linked to elevated amounts of depression, and receiving more information about HF help to lower the illness (p.52).
QOL among patients as discussed by Rice, Say, & Betihavas, 2018 (as cited in Leavitt et al., 2020) who receive personal support by nurses and recognize their medication regimen, dietary guidelines, and exercise suggestions are more likely to think that they can handle this health challenge and experience better QOL. On the other hand, Sevilla-Cazes et al., (2018) noted that patients are considering hospital readmission as a reasonable option, as per patients point of view, QOL at home is vague, as they experience emotional stress at home. Similarly, Park et al., (2009) focus on self-efficacy, to make lifestyle modifications to better QOL among patients, dealing with HF (p.53). The researchers found that HF patients experience an increased rate of emotional distress, and depression due to which they deny sticking to the medication regimen (Turrise, 2016).
Limitation: The inconsistencies discovered may result from several limitations that are realized in the materials reviewed by Sevilla-Cazes et al., (2018). These can result from a small group of patients, demographic factors, or less face-to-face contact with the patients. Turrise, (2016) comprises that, “its cross-sectional design, which does not allow for assessment of changes in variables over time”. Similarly, Leavitt et al., (2020) observed that more than half of the patients in the group are not being contacted by the nurses. Researchers noticed that the participants were only contacted twice throughout the study, the focus was on the male candidates, as stated in Park et al., (2009).
To gain a thorough awareness of HF readmission among older adults, it is necessary to operate a study that investigates all aspects of HF readmission to the hospitals. This incorporates, but is not restricted to, home management of HF, adherence to the medication regimen, QOL. The cause of HF readmission of each patient may be different, and this is supported by the inconsistencies between nurse and patient. As each cause of readmission makes a difference in HF individuals’ lives, it is essential to analyze the influence of all causes of HF readmission among older adults.