Transitional care for people living with dementia: perspectives of long-term care providers

Abstract

The purpose of this study is to examine transitional care of older adults living with dementia when transitioning from hospital or community settings into long-term care facilities. This study contributes to the current body of literature on transitional care by focusing on the experiences of long-term care providers and investigating how transitions occur, are negotiated, and stabilised through the service delivery system. This research not only provides a description of how transitional care occurs but also draws on interview data from long-term care providers and other professionals alongside documentary material, including policy documents, to understand the nature of transitional care. Using Situational Analysis (SA), supported by Actor-Network Theory (ANT) as a complementary theoretical lens, allows a dynamic view of transitional care as an interaction between humans and nonhumans. The participants in the study explained that transitional care is not a straightforward or logical process; instead, it is a complex and ongoing negotiation influenced by factors like time, paperwork, workplace culture, and scattered information. Formal systems were found to devalue the relational and experiential knowledge of long-term care providers while emphasising their accountability for high-quality care. Shortcomings were noted within the formal systems related to planning, assessment, and communication processes. Furthermore, the study found that meaningful improvements to transitional care for individuals living with dementia would require structural and cultural transformations that recognise relational labour and foster a more collaborative and cohesive approach to transitional care. Finally, the study demonstrated that emotional and relational labour played a significant role in stabilising transitions in the absence of systemic coherence.