Elderly patients’ participation in emergency medical services when offered an alternative care pathway

Abstract

As organizational changes in the healthcare system are in progress, to enhance care quality and reduce costs, it is important to investigate how these changes affect elderly patients’ experiences and their rights to participate in the choice of healthcare. The aim of this study is to describe elderly patients’ lived experience of participating in the choice of healthcare when being offered an alternative care pathway by the emergency medical services, when the individual patient's medical needs made this choice possible. This study was carried out from the perspective of caring science, and a phenomenological approach was applied, where data were analysed for meaning. Data consist of 11 semi-structured interviews with elderly patients who chose a healthcare pathway to a community-based hospital when they were offered an alternative level of healthcare. The findings show that the essence of the phenomenon is described as “There was a ray of hope about a caring encounter and about being treated like a unique human being”. Five meaningful constituents emerged in the descriptions: endurable waiting, speedy transference, a concerned encounter, trust in competence, and a choice based on memories of suffering from care. The conclusion is that patient participation in the choice of a healthcare alternative instead of the emergency department is an opportunity of avoiding suffering from care and being objectified.

Ambulance nurses' experiences of deciding a patient does not require ambulance care

“…Patients who were found to be hard to assess in the results of this study were older people. Vicente, Castren, Sjöstrand, and Wireklint Sundström (2013) interviewed elderly patients who sought emergency services for a certain period. Hospitals are associated with survival and security, a place where expertise and necessary care are gathered.…”

Caring science research in the ambulance services: an integrative systematic review

“…Oxygen reduced nausea and vomiting in patients with minor trauma and they were more satisfied with care when oxygen was administrated (82). Studies on elderly patients who were offered special care pathways show that they experienced the professionals as committed and thoughtful (83,84).…”

Patient participation in municipal elderly care from the perspective of nurses and occupational therapists

“…However, the person may have low self-esteem (Larsson, Sahlsten, Segesten, & Plos, 2011) and will assume a passive role which may mean being marginalized (Aasen, Kvangarsnes, & Heggen, 2012;Halskov, Lauridsen, & Hoffman, 2017). To express needs and be able to participate in and influence, healthcare decisions can require courage (Vicente, Castren, Sjöstrand, & Sundström, 2013) and self-confidence (Foss, 2011), and even if older persons do not participate in decision-making, they may still want to have the opportunity of participating in their care (Foss & Hofoss, 2011). However, nothing takes place in a vacuum; the environment dynamically influences participation (Hammel et al, 2008).…”