Anne Hedegaard Arndt, Merete Gregersen, Linda Huibers, Viola Burau, Maria Lundsby Jensen, Anna Dalsgaard Thorsen, Lone Winther Lietzen
Communication strategies were not examined as a primary research focus, resulting in heterogeneous descriptions and limited clinical guidance. HaH-AA research should explicitly address communication for acutely ill older adults, including those living with frailty.
PURPOSE: Hospital-at-Home Admission Avoidance (HaH-AA) provides hospital-level treatment at home as an alternative to hospital admission. Communication is key to safe, coordinated care for older adults, many of whom live with frailty. This review aimed to identify and map communication strategies and healthcare professionals involved in HaH-AA models for acutely ill older adults whilst charting reported frailty measures and frailty-related characteristics.
METHODS: This scoping review followed the Arksey and O'Malley framework. Four databases were searched to July 2025 to identify studies describing communication strategies in HaH-AA models for acutely ill older adults. A Communication Strategy Framework guided data extraction across three domains: face-to-face, technology- and organisational-mediated communication. Frailty measures and frailty-related characteristics were extracted when available.
RESULTS: Twenty-eight papers describing fifteen HaH-AA models were included. Face-to-face communication was described in all models for initial assessment and follow-up, delivered by nurses and physicians on-site, by nurses with remote physician input, or by nurses alone. Technology-mediated communication was described in 12 models as virtual visits (telephone or video), remote monitoring in 7 models using automated or manual methods. Organisationally mediated communication strategies were described across all models and included shared documentation and coordination mechanisms centred on four themes: standardised protocols, structured communication processes, dedicated coordination roles and shared training initiatives. Frailty-related reporting was heterogeneous; most studies reported frailty measures and frailty-related characteristics, but only four reported validated frailty measures.
CONCLUSION: Communication strategies were not examined as a primary research focus, resulting in heterogeneous descriptions and limited clinical guidance. HaH-AA research should explicitly address communication for acutely ill older adults, including those living with frailty.