Feeling Respected as a Person: a Qualitative Analysis of Frail Older People’s Experiences on an Acute Geriatric Ward Practicing a Comprehensive Geriatric Assessment

Abstract

Comprehensive geriatric assessment (CGA) practices multidimensional, interdisciplinary, and diagnostic processes as a means to identify care needs, plan care, and improve outcomes of frail older people. Conventional content analysis was used to analyze frail older people’s experiences of receiving CGA. Through a secondary analysis, interviews and transcripts were revisited in an attempt to discover the meaning behind the participants’ implied, ambiguous, and verbalized thoughts that were not illuminated in the primary study. Feeling “respected as a person” is the phenomenon participants described on a CGA acute geriatric ward, achieved by having a reciprocal relationship with the ward staff, enabling their participation in decisions when engaged in communication and understanding. However, when a person was too ill to participate, then care was person-supportive care. CGA, when delivered by staff practicing person-centered care, can keep the frail older person in focus despite them being a patient. If a person-centered care approach does not work because the person is too ill, then person-supportive care is delivered. However, when staff and/or organizational practices do not implement a person-centered care approach, this can hinder patients feeling “respected as a person”.

Comprehensive Geriatric Assessment for Frail Older People in Swedish Acute Care Settings (CGA-Swed): A Randomised Controlled Study

“…Findings on how frail older persons experience receiving care according to the CGA have already been published elsewhere based on this study, showing that they experienced being seen as a person while being admitted to a CGA ward [27].…”

“…The evaluation includes in-depth qualitative interviews with eight to ten participants in the intervention group, focusing on their experiences of receiving care according to the CGA [27]. The experiences of the staff working with to the CGA are explored through focus group discussions in order to gain an understanding of the intervention and its significance as well as its implementation.…”

“…There were also results indicating that the CGA increased patient safety [26]. Qualitative interviews with frail older people receiving care with the CGA at the intervention ward showed that they felt respected as persons when they were enabled to understand, engage in communication and participate in decisions [27]. The process evaluation alongside the RCT will add to the knowledge on the implementation of the CGA.…”

Exploration of how to make the collaborative planning process work - a grounded theory study

“…Not all professionals have the desire to practice personcentredness, and the organization and care environment do not always support practice in a way that fosters partnership (Ells et al, 2011). Learning to practice according a person-centred approach is challenging and time consuming (Westgård et al, 2019). Professionals need basic knowledge, attitudes and skills (Morgan & Yoder, 2012), and management should provide targeted education and training and create continual fora for discussions related to personcentredness and the collaborative care planning process to achieve and maintain the new way of working.…”

New Variations on the Theme of Multidimensional Geriatric Assessment

“…Implemented or anticipated assessment-based models of “co-care” with other specialties, allied health providers, or for special clinical populations, are the subject of several reports [ 7 , 8 , 9 , 10 ]. One offering describes a protocol for a new experimental trial of comprehensive geriatric assessment in an acute care unit [ 11 ]; as person-centeredness is a common fundamental concern of clinicians and teams performing such assessments, it is fitting to have a second qualitative study on this topic from the same group [ 12 ]. Attention to common geriatric syndromes (e.g., falls) and assessment in developing countries and in multicultural immigrant populations is demonstrated in two other reports [ 13 , 14 ].…”