Running head: LIVING IN LIMBO
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Living in the Limbo:
What it is Like to be Alternate Level of Care Patient.
Elena Ezhova
3305991
Athabasca University
Understanding Research
NURS 328
Barbara Wilson-Keates
March 19, 2019
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Living in the Limbo: What it is Like to be Alternate Level of Care Patient.
The purpose of this assignment is to gain an understanding of the research process by
developing a research proposal. The problem and significance of the problem and available
research will be discussed first. Next, I will present the research question, chosen approach and
design, target and accessible population, sampling and recruitment procedures. Then, I will
access the researchability and feasibility. Finally, I will conclude with an examination of what
was discovered about the process of developing a research study.
Over the past few decades, one of the areas of research has been the quality of life [QoL]
among older adults (Broudeur, Hurrell, Stepinska, & Houxou, n.d.). QoL is a multidimensional
concept that encompasses the individual’s physical health, psycho-social well-being and
functioning, independence, control over life, material circumstances, and external environment
(Bowling, 2007, p. 15). After hospitalization, many seniors are unable to return home as they
require special care after discharge and remain in acute care for a long time as Alternate level of
Care [ALC] patients (McCloskey, Jarrett, Stewart, & Nicholson, 2014, p. 88
). ALC patients are
patients who occupy hospital beds but do not require the intensity of services provided (Canadian
Institutes for Health Information (CIHI), 2009, p. 6
). Patients with cognitive impairment,
behavioural challenges, functional decline, social vulnerability, advanced age, lack of support
system are frequently being designated as ALC patients (Costa, Poss, Peirce, & Hirdes, 2012, p.
172).
In 2014, up to 33% of acute care beds in Canada had been occupied by ALC patients with
an average length of hospital stay 380 days (Canadian Medical Association, 2016, p. 11).
The Research Problem and the Problem Statement.
Despite data collection since 1989, the experiences of ALC patients have not been
examined yet
(CIHI, 2009, p. 2
). The purpose of this study is to explore the effects of prolonged,
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unnecessary hospitalization on older patients.
The Significance of the Problem.
Canadian Medical Association (2016) indicated that extended hospitalization of the
elderly might result in hospital-acquired disability (p. 12).
It has been suggested that ALC
patients may experience reduced QoL and a financial burden (Kuluski et al., 2017, p. 1
).
Assessing patient’s QoL captures patients' perspectives of their disease and treatment, their
perceived need for health care, and their preferences for treatment and outcomes (Carr &
Higginson, 2001, p. 1357). Full understanding of the impact of lengthy hospitalization on the
patient's QoL is needed to guide targeted strategies for improving the situation.
