Informal Caregivers in Transitional Hospital-to-Home Care for Older People: Addressing Gaps in Pre-Discharge Collaboration for Enhanced Patient Outcomes.

With aging populations worldwide, informal caregivers (ICs) play an essential role in transitional hospital-to-home care for older people, providing essential first-line support, clinical assistance, emotional care, and crucial coordination of care. However, their involvement in discharge planning remains insufficiently recognized, potentially compromising patient safety and continuity of care. Despite their vital contributions and growing policy initiatives, ICs' involvement in hospital discharge planning remains insufficiently recognized. This lack of structured integration leads to significant gaps in communication, education, and collaborative care planning-factors that can compromise patient safety, disrupt continuity of care, and increase caregiver burden. ICs often report feeling unheard and excluded from key decisions, which contributes to adverse outcomes for both patients and ICs. Addressing these gaps requires comprehensive systemic changes aimed at formalizing the role of ICs in professional training, hospital discharge protocols, and integrating ICs meaningfully into care decision-making processes. This perspectives article provides an overview of the current state of IC involvement in transitional care, reflects on its relevance among healthcare professionals, policymakers, and researchers, and explores the implications for patient safety and health outcomes. Drawing on evidence-based models such as the Transitional Care Model and Better Outcomes for Older people through Safe Transitions, the article discusses key strategies to enhance IC participation. These include raising awareness among professional caregivers, improving communication and information transfer, formally recognizing and integrating ICs as care partners, and leveraging technology and support systems tailored to their needs. By fostering structured partnerships and collaborative approaches with ICs, healthcare systems can improve the quality and safety of transitional care while alleviating caregiver burden and promoting better long-term health trajectories for older people.