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Abstract Introduction Inclusion of informal carers in transitional care is challenging because of fast throughput and service fragmentation. This study aimed to understand informal carers' needs during the care transitions of older adults from inpatient care to the community. Methods A qualitative exploratory design was used with mixed‐methods data collection. Seventeen semi‐structured telephone interviews were conducted with family carers; one focus group was conducted by videoconference with two family carers and three community‐based advocacy and aged care providers; and eight semi‐structured telephone interviews were undertaken with healthcare practitioners from rehabilitation services. Data were thematically analysed. Findings All carers described the main social challenge that they needed to address in transitional care as ‘Needing to sustain family’. Carers reported their social needs across five solutions: ‘Partnering with carers’, ‘Advocating for discharge’, ‘Accessing streamlined multidisciplinary care’, ‘Knowing how to care’ and ‘Accessing follow‐up care in the community’. Focus group participants endorsed the findings from the carer interviews and added the theme ‘Putting responsibility back onto carers’. All healthcare practitioners described the main social challenge that they needed to address as ‘Needing to engage carers’. They reported their social solutions in three themes: ‘Communicating with carers’, ‘Planning with carers’ and ‘Educating carers’. Discussion Findings highlight the importance of reconstructing the meaning of transitional care and relevant outcomes to be inclusive of carers' experiences and their focus on sustaining family. Transitional care that includes carers should commence at the time of hospital admission of the older adult. Conclusions Future sustainable and high‐quality health services for older adults will require transitional care that includes carers and older adults and efficient use of inpatient and community care resources. Healthcare professionals will require education and skills in the provision of transitional care that includes carers. To meet carers' support needs, models of transitional care inclusive of carers and older adults should be developed, implemented and evaluated. Public Contribution This study was conducted with the guidance of a Carer Advisory Group comprising informal carers with experience of care transitions of older adults they support and community‐based organizations providing care and advocacy support to informal carers.

Abstract Background Informal carers play an important role in the care of patients with mental illness. Little is known of the relationship experience of the patient and their informal carer (caring dyad) as the context for the intersection between physical and mental health. Aim This study aimed to explore the impact of comorbid cardiometabolic risk (CMR), metabolic syndrome (MetS) and related diseases and severe mental illness (SMI) on the caring dyad. Design Between October 2018 and March 2020, we conducted 11 in‐depth semi‐structured interviews across 6 adult caring dyads, interviewing each individual separately. Setting Dyads were recruited within the United Kingdom; informal carers were nominated by the patient as a person who provided a significant amount of support. Variable Being Studied Participants were asked about the impacts of illness and caring on daily life. Data Analysis Data were analysed at the dyad level using thematic analysis, comparing and contrasting responses from each individual. Results Themes were identified: enhanced closeness, dissonance and balance within the caring dyad. Discussion and Conclusions This study uses a particular population of patients with comorbid CMR factors, MetS and related diseases and SMI and their informal carers to explore the relevance and utility of caring dyads as an analytical framework to inform practice and policy. Future interventions should consider factors impacting on dyadic relationships to formulate effective and sustainable dyadic care and treatment to improve health outcomes for both patients with SMI and their informal carers. Patient/Public Involvement In this study, patients and informal carers were participants. Topic guides were piloted with a patient and informal carer.

Introduction: Inclusion of informal carers in transitional care is challenging because of fast throughput and service fragmentation. This study aimed to understand informal carers' needs during the care transitions of older adults from inpatient care to the community., Methods: A qualitative exploratory design was used with mixed-methods data collection. Seventeen semi-structured telephone interviews were conducted with family carers; one focus group was conducted by videoconference with two family carers and three community-based advocacy and aged care providers; and eight semi-structured telephone interviews were undertaken with healthcare practitioners from rehabilitation services. Data were thematically analysed., Findings: All carers described the main social challenge that they needed to address in transitional care as 'Needing to sustain family'. Carers reported their social needs across five solutions: 'Partnering with carers', 'Advocating for discharge', 'Accessing streamlined multidisciplinary care', 'Knowing how to care' and 'Accessing follow-up care in the community'. Focus group participants endorsed the findings from the carer interviews and added the theme 'Putting responsibility back onto carers'. All healthcare practitioners described the main social challenge that they needed to address as 'Needing to engage carers'. They reported their social solutions in three themes: 'Communicating with carers', 'Planning with carers' and 'Educating carers'., Discussion: Findings highlight the importance of reconstructing the meaning of transitional care and relevant outcomes to be inclusive of carers' experiences and their focus on sustaining family. Transitional care that includes carers should commence at the time of hospital admission of the older adult., Conclusions: Future sustainable and high-quality health services for older adults will require transitional care that includes carers and older adults and efficient use of inpatient and community care resources. Healthcare professionals will require education and skills in the provision of transitional care that includes carers. To meet carers' support needs, models of transitional care inclusive of carers and older adults should be developed, implemented and evaluated., Public Contribution: This study was conducted with the guidance of a Carer Advisory Group comprising informal carers with experience of care transitions of older adults they support and community-based organizations providing care and advocacy support to informal carers., (© 2022 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Background: Informal carers play an important role in the care of patients with mental illness. Little is known of the relationship experience of the patient and their informal carer (caring dyad) as the context for the intersection between physical and mental health., Aim: This study aimed to explore the impact of comorbid cardiometabolic risk (CMR), metabolic syndrome (MetS) and related diseases and severe mental illness (SMI) on the caring dyad., Design: Between October 2018 and March 2020, we conducted 11 in-depth semi-structured interviews across 6 adult caring dyads, interviewing each individual separately., Setting: Dyads were recruited within the United Kingdom; informal carers were nominated by the patient as a person who provided a significant amount of support., Variable Being Studied: Participants were asked about the impacts of illness and caring on daily life., Data Analysis: Data were analysed at the dyad level using thematic analysis, comparing and contrasting responses from each individual., Results: Themes were identified: enhanced closeness, dissonance and balance within the caring dyad., Discussion and Conclusions: This study uses a particular population of patients with comorbid CMR factors, MetS and related diseases and SMI and their informal carers to explore the relevance and utility of caring dyads as an analytical framework to inform practice and policy. Future interventions should consider factors impacting on dyadic relationships to formulate effective and sustainable dyadic care and treatment to improve health outcomes for both patients with SMI and their informal carers., Patient/public Involvement: In this study, patients and informal carers were participants. Topic guides were piloted with a patient and informal carer., (© 2021 The Authors. Health Expectations Published by John Wiley & Sons Ltd.)