Lost In Transition: A Review of Current Facility-Based Short-Stay Care Models for Older Adults in Ireland

Abstract Background Facility-based short-stay care (SSC) is increasingly utilised to support older adults transitioning from acute hospital settings. Since 2015 the service has expanded, partly in response to access and discharge issued during the COVID 19 pandemic, however, these access and discharge issues remain. Inconsistencies in terminology, care models, and outcomes challenge both international and national policy and practice, particularly in Ireland where governance, service capability, and outcome monitoring are fragmented. This review aimed to characterise international SSC models, assess their clinical and economic impacts, understand user experiences, and evaluate Ireland’s current SSC framework. Methods A scoping reviewC:\Users\amkilgannon\Downloads\applewebdata:\6A092C91-6AB4-4024-804F-C187137E9BF7 - _msocom_1 of international literature was conducted alongside a system-level analysis of SSC in Ireland, including public and private sector models. Key data on governance, capacity, interventions, and outcomes were synthesized. Results Internationally, SSC models integrate core components such as multidisciplinary care, comprehensive geriatric assessment, and coordinated discharge planning, yet lack standardised outcome metrics. Older adults have frequently expressed diminished autonomy and increased dependency within this model of care. Evidence on their effectiveness remains mixed. In Ireland, SSC is primarily delivered through private nursing homes under Transitional Care Funding and other schemes, often without adequate regulation or consistent care delivery. Data indicate variable patient outcomes, limited access to allied health services, high rates of readmission, long lengths of stay, and substantial public spending exceeding €120 million annually.C:\Users\amkilgannon\Downloads\applewebdata:\5921ECC9-86DF-407F-AA22-36BD3808C81E - _msocom_1 C:\Users\amkilgannon\Downloads\applewebdata:\5921ECC9-86DF-407F-AA22-36BD3808C81E - _msoanchor_1 Conclusion SSC has the potential to play a pivotal role in post-acute care for older adults, but current models in Ireland require major reform. Integrated governance, outcome-based evaluation, service redesign, and robust economic analyses are urgently needed to ensure care quality, safety, and efficiency.