‘Patients come with two garbage bags full of problems and we have to sort them.’ A qualitative study of the experiences of healthcare professionals on patients admitted to short-term residential care in the Netherlands

2021 ◽  
Author(s):  
Judith H van den Besselaar ◽  
Linda Hartel ◽  
Joost D Wammes ◽  
Janet L MacNeil-Vroomen ◽  
Bianca M Buurman
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
The Netherlands ◽  
Residential Care ◽  
General Health ◽  
Healthcare Professionals ◽  
Health Problems ◽  
Short Term ◽  
Patient Journey ◽  
Return Home

Abstract Background Short-term residential care (STRC) facilities were recently implemented in the Netherlands to provide temporary care to older adults with general health problems. The aim of STRC is to allow the individual to return home. However, 40% of patients are discharged to long-term care facilities. In-depth data about characteristics of patients admitted and challenges in providing STRC are missing. Objective To obtain perspectives of STRC professionals on the patient journey from admission to discharge. Design Qualitative study. Setting Eight nursing homes and three hospitals. Subjects A total of 28 healthcare professionals. Methods A total of 13 group interviews with in-depth reviews of 39 pseudonymised patient cases from admission to discharge. Interviews were analysed thematically. Results Many patients had complex problems that were underestimated at handover, making returning to home nearly impossible. The STRC eligibility criteria that patients have general health problems and can return home do not fit with current practice. This results in a mismatch between patient needs and the STRC that is provided. Therefore, planning care before and after discharge, such as advance care planning, social care and home adaptations, is important. Conclusions STRC is used by patients with complex health problems and pre-existing functional decline. Evidence-based guidelines, appropriate staffing and resources should be provided to STRC facilities. We need to consider the environmental context of the patient and healthcare system to enable older adults to live independently at home for longer.

scholarly journals The psychosocial adaptability of independently living older adults to COVID‐19 related social isolation in the Netherlands: A qualitative study

2021 ◽  
Author(s):  
Evi M. Kremers ◽  
Jeroen H. M. Janssen ◽  
Minke S. Nieuwboer ◽  
Marcel G. M. Olde Rikkert ◽  
G. M. E. E. (Geeske) Peeters
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
The Netherlands ◽  
Social Isolation

scholarly journals Exploring the Experienced Impact of Studentification on Ageing-in-Place

2019 ◽  
Vol 4 (2) ◽  
pp. 96-105 ◽  
Author(s):  
Debbie Lager ◽  
Bettina Van Hoven
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Health Services ◽  
The Netherlands ◽  
Public Transport ◽  
Negative Experiences ◽  
Ageing In Place ◽  
Neighbourhood Change ◽  
Negative Impacts ◽  
Depth Interviews

In this qualitative study we explore the experienced impact of studentification on ageing-in-place (i.e., ageing in one’s own home and neighbourhood for as long as possible). Studentification, which refers to concentrations of students in residential neighbourhoods, has been associated with deteriorating community cohesion by several authors. This can negatively affect existing neighbourhood support structures. In examining this topic, we draw on in-depth interviews with 23 independently living older adults (65+) which were conducted in a studentified urban neighbourhood in the Netherlands. Our results show how the influx of students in the neighbourhood negatively affected older adults’ feelings of residential comfort. In spite of this, none of the participants expressed the desire to move; they experienced a sense of familiarity and valued the proximity of shops, public transport and health services, which allowed them to live independently. To retain a sense of residential mastery, our participants dealt with negative impacts of studentification, at least in part, by drawing on accommodative coping strategies that weigh in broader experiences of physical and social neighbourhood change. In doing so, they rationalised and reassessed their negative experiences resulting from studentification. We discuss the implications of our findings for the development of age-friendly neighbourhoods.

scholarly journals Developing an individualised cross-sectoral programme based on activities of daily living to support rehabilitation of older adults with hip fracture: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044539
Author(s):  
Alice Ropke ◽  
Karina Lund ◽  
Camilla Thrane ◽  
Carsten Juhl ◽  
Anne-Le Morville
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Qualitative Study ◽  
Activities Of Daily Living ◽  
Hip Fractures ◽  
Daily Living ◽  
Research Council ◽  
Healthcare Professionals ◽  
Rehabilitation Programme ◽  
Trial Registration

ObjectivesTo develop an individualised rehabilitation programme for personal and instrumental activities of daily living (ADL) tasks, enabling older adults with hip fractures to perform ADL safely and independently.DesignQualitative study inspired by the complex intervention development (Medical Research Council framework phase I) using literature search and research circles.SettingsUniversity Hospital of Copenhagen, Herlev and Gentofte, and Herlev and Gentofte municipalities.ParticipantsOne research circle with seven older adults with hip fractures, and one with seven healthcare professionals (occupational therapists and physiotherapists).ResultsThree generic categories were identified: (1) ‘Challenge older adults with goal-oriented ADL tasks’, (2) ‘Implement strategies to enhance independent and safe performance of ADL tasks’, and (3) ‘Communicate the important information to the target group and across sectors’. A programme was developed and an intervention to enhance usual rehabilitation was designed comprising: an individualised intervention component consisting of five additional therapy sessions; one during hospitalisation, four in the municipality and a follow-up phone call.ConclusionsEngaging and integrating activities into rehabilitation treatment may support rehabilitation. Our study highlighted the need for setting individual goals and challenging older adults with hip fracture by providing guidance in strategies to enhance safe and independent performance of ADL tasks. Furthermore, the need for providing older adults with hip fracture and healthcare professionals with written and oral information about goal setting during the transitional rehabilitation phase was emphasised. Including the perspectives of older adults with hip fracture and healthcare professionals added value to the rehabilitation, and thus ensured an adequate, tangible and implementable rehabilitation programme.Trial registration numberThis article is the first of three articles inspired by Medicial Research Council guidelines. The next study is a feasibility study with the trial registration: ClinicalTrials.gov ID: NCT03828240. The results are right now being written in article. The third study is a randomised controlled trial with the trial registration: ClinicalTrials.gov ID: NCT04207788; Pre-results.

scholarly journals Current wishes to die; characteristics of middle-aged and older Dutch adults who are ready to give up on life: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Roosmarijne M. K. Kox ◽  
H. Roeline W. Pasman ◽  
Martijn Huisman ◽  
Wim Benneker ◽  
Bregje D. Onwuteaka-Philipsen
Keyword(s):  
Older Adults ◽  
The Netherlands ◽  
Cross Sectional Study ◽  
Health Problems ◽  
Sectional Study ◽  
Middle Aged ◽  
Cross Sectional ◽  
Age Related ◽  
Wish To Die ◽  
A Current

Abstract Background Literature shows that middle-aged and older adults sometimes experience a wish to die. Reasons for these wishes may be complex and involve multiple factors. One important question is to what extent people with a wish to die have medically classifiable conditions. Aim (1) Estimate the prevalence of a current wish to die among middle-aged and older adults in The Netherlands; (2) explore which factors within domains of vulnerability (physical, cognitive, social and psychological) are associated with a current wish to die; (3) assess how many middle-aged and older adults with a current wish to die do not have a medically classifiable condition and/or an accumulation of age-related health problems. Methods Data of 2015/16 from the Longitudinal Aging Study Amsterdam were used for this cross-sectional study (1563 Dutch middle-aged and older adults aged between 57 and 99 years), obtained through structured medical interviews and self-reported questionnaires. Three experienced physicians assessed whether the participants with a current wish to die could be classified as having a medically classifiable condition and/or an accumulation of age-related health problems. Results N = 62 participants (4.0%) had a current wish to die. Having a current wish to die was associated with multiple characteristics across four domains of vulnerability, among which: self-perceived health, problems with memory, self-perceived quality of life and meaningfulness of life. Fifty-four participants with a current wish to die were assessed with having a medically classifiable condition, of which one was also assessed with having an accumulation of age-related health problems. Six people were assessed to have neither, and for two people it was unclear. Conclusion A small minority of middle-aged and older adults in the Netherlands have a current wish to die. Most of them can be classified with a medical condition and one person with an accumulation of age-related health problems. Furthermore, the findings show that having a current wish to die is multi-faceted. There is still a need for more knowledge, such as insight in to what extent suffering stemming from the medical classifiable disease contributes to the development of the wish to die.

scholarly journals The Life Experiences of Community Older Adults With Mental Illness in Taiwan: A Qualitative Study

2017 ◽  
Vol 3 (1) ◽  
pp. 158
Author(s):  
Su-Jung Liao ◽  
Jiin-Ru Rong ◽  
Tse-Tsung Liu ◽  
Hsiao-Ju Sun
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Illness ◽  
Qualitative Study ◽  
Elderly Patients ◽  
Elderly People ◽  
Mental Health Problems ◽  
Life Experience ◽  
Life Experiences ◽  
Health Problems

Aims: The risk of mental illness and mental health problems is known to increase with aging, there is a continuing need for research and information about the daily life and care needs of elderly people with mental illness. The aim of this study was to examine the real-life experience of elderly outpatients with mental illnesses in Taiwan communities through in-depth interviews.Methods: A qualitative study involving semi-structured interviews of mentally ill elderly patients was conducted in 15 participants (3 men and 12 women, mean age = 74.67 years, SD = 10.04 years).Results: The willpower to survive and cope with aging and mental health problems was identified as the core category of the life experiences in the older adults in this study. The struggle with the stress of aging and mental health problems was categorized in life-experience terms as ‘bear the bitterness of life,’ ‘adhere to psychiatric treatment and use resources to cope with life’s stress,’ ‘maintain the willpower to survive’. Results of this study shown that although elderly patients in community have had many stressful life experiences and problems with mental illness, they will continue to show strength to coping with the problems of aging and mental illnesses.Conclusions: The elderly mental illness patients could coping with their problems, and maintain an active lifestyle, accept the reality and arrange life, and connect with the community. Therefore, health professionals should help elderly people find new strategies to maintain their mental health and to function in their communities.

scholarly journals A Qualitative Study of the Cognitive Rehabilitation Program GRADIOR for People with Cognitive Impairment: Outcomes of the Focus Group Methodology

2021 ◽  
Vol 10 (4) ◽  
pp. 859
Author(s):  
Eider Irazoki ◽  
Mª Cruz Sánchez-Gómez ◽  
Leslie María Contreras-Somoza ◽  
José Miguel Toribio-Guzmán ◽  
Mª Victoria Martín-Cilleros ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Focus Group ◽  
Qualitative Study ◽  
Cognitive Rehabilitation ◽  
Healthcare Professionals ◽  
Rehabilitation Program ◽  
Neuropsychological Rehabilitation ◽  
People With Dementia ◽  
Focus Group Methodology

In recent years, technology has been implemented in the field of interventions for older adults. GRADIOR 4.5 is a cognitive software within the wide variety of available multimedia programs that support healthcare professionals in cognitive assessment and neuropsychological rehabilitation. The study aimed to evaluate the new version of GRADIOR (v4.5) based on the experience of people with mild cognitive impairment (MCI), people with dementia (PWD), and healthcare professionals. A qualitative study using the focus group methodology was carried out involving 13 people with MCI, 13 PWD, and 11 healthcare professionals. An analysis of the content and the level of feedback was performed. The study showed that GRADIOR 4.5 might be sufficiently adapted to PWD and people with MCI. Participants were motivated to use GRADIOR 4.5, showed high acceptability of the software, and a positive attitude towards technology. However, healthcare professionals suggested significant improvements to the software. GRADIOR 4.5 appeared to be a promising intervention that, because of its positive experience and acceptability, could be systematically implemented to complement cognitive rehabilitation interventions for older adults with MCI and dementia. Finally, it is advisable to consider the suggestions gathered in this study for future developments.

scholarly journals Anticipating the future of the child and family in pediatric palliative care: a qualitative study into the perspectives of parents and healthcare professionals

2020 ◽  
Author(s):  
Lisa M. Verberne ◽  
Jurrianne C. Fahner ◽  
Stephanie F. V. Sondaal ◽  
Antoinette Y. N. Schouten–van Meeteren ◽  
Chris C. de Kruiff ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Ad Hoc ◽  
Healthcare Professionals ◽  
Pediatric Palliative Care ◽  
Open Approach ◽  
Future Scenarios ◽  
Short Term ◽  
The Future ◽  
Future Care

Abstract Preparing for future scenarios in pediatric palliative care is perceived as complex and challenging by both families and healthcare professionals. This interpretative qualitative study using thematic analysis aims to explore how parents and healthcare professionals anticipate the future of the child and family in pediatric palliative care. Single and repeated interviews were undertaken with 42 parents and 35 healthcare professionals of 24 children, receiving palliative care. Anticipating the future was seen in three forms: goal-directed conversations, anticipated care, and guidance on the job. Goal-directed conversations were initiated by either parents or healthcare professionals to ensure others could align with their perspective regarding the future. Anticipated care meant healthcare professionals or parents organized practical care arrangements for future scenarios with or without informing each other. Guidance on the job was a form of short-term anticipation, whereby healthcare professionals guide parents ad hoc through difficult situations. Conclusion: Anticipating the future of the child and family is mainly focused on achievement of individual care goals of both families and healthcare professionals, practical arrangements in advance, and short-term anticipation when a child deteriorates. A more open approach early in disease trajectories exploring perspectives on the future could allow parents to anticipate more gradually and to integrate their preferences into the care of their child. What is Known:• Anticipating the future in pediatric palliative care occurs infrequently and too late. What is New:• Healthcare professionals and parents use different strategies to anticipate the future of children receiving palliative care, both intentionally and unwittingly. Strategies to anticipate the future are goal-directed conversations, anticipated care, and guidance on the job.• Parents and healthcare professionals are engaged to a limited extent in ongoing explorative conversations that support shared decision-making regarding future care and treatment.

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