Nursing Home Transition: Implementing the Program Providing Assistance to Caregivers in Transition (PACT)

Newcomer, R., Graham, C.G., Sotelo, E., Anderson, L. (2004). Nursing Home Transition: Implementing the Program Providing Assistance to Caregivers in Transition (PACT). San Francisco, CA: Center for Personal Assistance Services.

Abstract

Objective: PACT is a case management program targeted on nursing home residents and their potential caregivers. It enhances discharge planning and continues case management support for a transitional period following a return to the community. Methods: Chart reviews, and staff, discharge planners, and participants interviews document program accomplishments and challenges. Results: The program received 76 referrals during its initial 24 months of operations, accepting 42. Of these 38 were discharged to the community. The average length of nursing home stay was 79 days. Five of those discharged returned to the nursing home within six months, three others died. Caregivers report satisfaction with the instrumental and emotional assistance. Nursing home cooperation was mixed with 60% of referrals coming from six of the county's 36 facilities.

Discussion: Results suggest the value of enhanced discharge planning, but that more work is needed to development and strengthen the referral base of for the program.

Key words: aged, nursing home, case management

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