Next of kin represent significant resources in the care for older patients. The aim of this study was to describe and illuminate the meaning of the next of kin’s experiences during the transition of an older person with continuing care needs from hospital to home. The study has a phenomenological hermeneutic design. Individual, narrative interviews were conducted, and the data analysis was conducted in accordance with Lindseth and Norberg’s phenomenological hermeneutic method. Two themes and four subthemes were identified and formulated. The first theme: “Balancing vulnerability and strength,” encompassed the subthemes “enduring emotional stress” and “striving to maintain security and continuity.” The second theme: “Coping with an altered everyday life,” encompassed “dealing with changes” and “being in readiness.” Our findings suggest that the next of kin in striving to maintain continuity and safety in the older person’s transition process are both vulnerable individuals and significant agents. Thus, it is urgent that health care providers accommodate both their vulnerability and their abilities to act, and thereby make them feel valued as respected agents and human beings in the transition process.

Aims and objectives. To describe and explore experiences of next of kin during the older persons' transition into long-term care. Background. Moving into long-term care is a challenge for both resident and next of kin. Next of kin experience transitions at the same time as they play significant parts in their family members' transition into long-term care placement. Design. Constructivist hermeneutical design. Methods. Ten next of kin to newly admitted eight residents were recruited by purposeful sampling and interviewed. Periodic participant observation periods following new residents on arrival day and the first week after admission and some written documentation were the backdrops to the interviews. Results. What happened prior to the long-term care placement as well as what happened in the initial period of transition influenced the experiences of next of kin. Characteristics of their experiences were: 'striving to handle the new situation', 'still feeling responsible', and 'maintaining dignity and continuity'. Conclusions. Next of kin were unprepared for the transition and had little support from staff. Staff lacked awareness about next of kin's transition experiences. Their involvement with next of kin was unpredictable, and this added to the burdens of next of kin in this period. Relevance to clinical practice. Knowledge about experiences of next of kin needs to be acknowledged among healthcare professionals. Health professionals need to pay attention to what happens across institutional borders within families as well as between staff and family members. Individual family members need support in this period of change.

The amount of older patients who are discharged from hospitals while continuing to need care is increasing in Norway. The transition between different care services has the potential for high rates of medication errors, incomplete or inaccurate information transfer, and lack of appropriate follow-up care. Thus, insight into the transition process is vital to understanding the complexity and vulnerability the patients are exposed to in this process. The aim of this phenomenological hermeneutic study was to describe and illuminate the lived experiences of older home residents during the transitions from hospital to home. Data were collected through narrative interviews, and an interpretation analysis based on a method developed by Lindseth and Norberg was conducted. Two themes and four subthemes, closely related to each other emerged from the structural analysis of the text: The theme "Relating to different systems of care" with the two subthemes "feeling disregarded" and "being humble"; and the theme "Adapting to life conditions" with the two subthemes "feeling vulnerable" and "coping with alterations". The older people miss being seen as human beings as well as patients during the transition process. Despite the lack of information and participation in the transition process, they were grateful and humble to the systems of care they were a part of. This, however, also encompassed rejections of own needs. It is urgent that health care professionals focus on the older person's individual needs and preferences. This means that care must be considered from the perspectives of the older person's biographical as well as medical history, and the complexity of the situation.