Key result
In-depth interviews with 25 low-income older adults revealed that medical disability post-discharge was amplified by socioeconomic disability, leading to shame and difficulty asking for help.
Observational (n=25)
No
Socioeconomic stressors significantly amplify medical disability during the post-hospital transition for low-income older adults, highlighting the need for empathic support and targeted interventions.
May warrant screening for socioeconomic barriers in care transitions; hypothesis-generating and requires prospective validation.
BACKGROUND: Older adults of low socioeconomic status are at high risk for poor post-hospital outcomes. Design. A qualitative researcher, who was also an outreach worker from the West Philadelphia community, conducted in-depth interviews with 25 participants within 30 days of their hospital discharge. PARTICIPANTS: Eligible participants were: 1) residents of high-poverty ZIP codes; 2) dually eligible for Medicare and Medicaid; 3) had capacity or a caregiver who could be interviewed as a proxy; 4) general medicine or cardiology patients. RESULTS: Participants were unable to access the care and accommodations needed to cope with post-hospital frailty. As a result, medical disability was amplified by socioeconomic disability. Participants were ashamed of the resulting loss of control and had difficulty asking for help, particularly from potential supports who were perceived as emotionally controlling or judgmental. CONCLUSION: Strategies that address socioeconomic stressors of hospitalization and provide empathic support may improve the post-hospital transition for these high-risk individuals.
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Kangovi et al. (2014) conducted an observational in Post-hospital transition in low socioeconomic status older adults (n=25). In-depth qualitative interviews was evaluated on Perspectives on post-hospital transition. In-depth interviews with 25 low-income older adults revealed that medical disability post-discharge was amplified by socioeconomic disability, leading to shame and difficulty asking for help.
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