Older people returning home after unplanned hospital admissions often experience fragmented care, leading to poor health outcomes and rehospitalisation. Taking a person-centred approach, we co-designed and piloted a care transition service with older people, their carers, and health professionals, to improve the care of older people as they transitioned from hospital to home. We conducted five co-design workshops with healthcare professionals and older people who had experienced frequent hospital presentations, to explore ways to improve the transition from hospital to home. The workshops culminated in the co-design of a Care transition Coordinator (CTC) role. We undertook a 6-month pilot study in one metropolitan hospital in Adelaide, Australia, to determine the feasibility and preliminary effectiveness of the role from an older person and health system perspective. Descriptive data were extracted from Comprehensive Geriatric Assessments, action sheets, patient checklists, and hospital databases, while semi-structured interviews were conducted with service users, providers, and referrers and thematically analysed to provide qualitative insights into the service. Thirty-five older people were cared for by the CTC during their transition from hospital to home. The CTC was perceived to meet the needs of older people and was well received by older people, their families/carers, and referrers. However, there were some challenges to the feasibility of the service from a service-provider perspective. Our findings indicate that it is possible to engage frail, older people who are frequent hospital presenters in a co-design process, and to design services that are informed by, and meet their needs.

Violence and abuse by grandchildren towards their grandparent kinship carers is an important but under-researched issue. Research evidence on the perceived legitimacy of aged-related myths, beliefs, and witchcraft accusations against older people, especially grandparents, in Ghana and Africa suggest that violence and abuse against grandparent kinship carers could be common. This study explored the types of violence or abuse experienced by grandparent kinship carers, and the meanings grandparents associate with the abuse. Thirty-one grandparents were recruited from four communities in Ghana following a horizontal network sampling approach and interviewed using a qualitative in-depth narrative storytelling strategy. Analysis of the narratives revealed three common types of abuse experienced by the grandparent kinship carers which were perpetrated by children living under their care: (1) insults and verbal abuse, (2) stealing and financial exploitation, and (3) physical threats. However, the grandparents rationalised and justified the abusive behaviours by attributing them to factors within the children’s eco-system, such as friends and household members. The findings highlighted three crucial interrelated factors that underlie these incidents of violence including cultural beliefs around witchcraft, family structural dynamics, and grandparents’ attitudes towards violence. Practical recommendations, including the development of a community normative change program, have been proposed to address violence by grandchildren towards grandparent kinship carers in Ghana.