Striving to maintain a dignified life for the patient in transition: Next of kin’s experiences during the transition process of an older person in transition from hospital to home

Abstract

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.

User participation is a family matter: A multiple case study of the experiences of older, hospitalised people and their relatives

“…“fighting on two fronts”), which is in line with descriptions found in other studies as well (e.g. struggling and striving to gain influence) (Aasen et al., ; Bragstad, Kirkevold, & Foss, ; Hvalvik & Reierson, ).…”

“…A recent review of the literature on older people's participation in transitions reveals low levels of participation on the part of the patients (Dyrstad, Testad, et al., ). Other studies have noted that relatives often are not allowed to participate in discharge planning according to their preferences (Bragstad, Kirkevold, Hofoss, et al., ; Hvalvik & Reierson, ).…”

“…Little research has been carried out on the experiences of relatives in connection with the discharge from hospital of elderly family members, particularly to their own homes (Hvalvik & Reierson, ). The transition processes have been found to be emotionally stressful to relatives who have struggled to maintain the elderly patient's dignity while balancing their own vulnerability (Hvalvik & Reierson, ). Only a few studies have focused on the quality of transitional care for the patient as well as the family (Allen, Hutchinson, Brown, & Livingston, ; Shepperd et al., ).…”

How older people enact care involvement during transition from hospital to home: A systematic review and model

“… This resulted in patients and caregivers moving between states of involvement in attempting to resolve a single aspect of care. Challenging and chasing, as the third type of involvement, highlighted the work and effort required to question staff and source information . Examples of chasing were seen exclusively in caregivers.…”

Health professionals’ perspectives on the discharge process and continuity of care for stroke survivors discharged home in regional Australia: A qualitative, descriptive study

“…Previous studies have emphasized the risk of suffering high carer stress (Aziz et al, ; Ekstam, Johansson, Guidetti, Eriksson, & Ytterberg, ; Kable et al, ; King et al, ). They also highlight the significance and complexity of the carer role during transitions between services and in maintaining continuity of care (Ghazzawi et al, ; Hvalvik & Reierson, ), and associated difficulty for carers when stroke survivors are discharged home. Carers need support (King et al, ), particularly with medications (Pindus et al, ), as they coordinate services and provide the stroke survivor with instrumental and emotional support (Aziz et al, ; Luker et al, ).…”