Carer engagement in the hospital care of older people: An integrative literature review

Aim: The aim of this review was to explore the concept of carer engagement in the hospital care of older people and to build theory to inform future research and practice. Background: Carer engagement can help to improve the delivery and continuity of care provided to older people in hospital. However, definitions, guidance and structures for carer engagement in hospitals are lacking and there can be tensions and conflicts about the role of carers in hospitals. Method: Integrative literature review. Literature searches identified 2745 peer-reviewed articles and studies published between January 1990 and November 2015 in the following databases: PubMed, Cochrane, Medline, EMBASE and CINHAL. After applying inclusion/exclusion criteria, the sample (103 articles) was subject to thematic analysis. Results: Current evidence on carer engagement is dispersed across different research literatures on clinical conditions and contexts. Six distinct components of carer engagement were identified: patient caregiving, information sharing, shared decision-making, carer support and education, carer feedback and patient care transitions. Conclusion: Hospitals can adopt a more consistent and comprehensive approach to carer engagement for older people by developing and supporting the different components of carer engagement identified. Implications for practice: The integrated model of carer engagement developed here could help staff and hospitals to develop strategies, staff training and resources that work with rather than against carers. The findings can inform future research on carer engagement interventions and associated outcomes for patients, carers and staff.