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Monday, 31 October 2011
Learning Objective 1: The learner will be able to relate the need for services to support older persons who are waiting in hospital for a nursing home bed.
Learning Objective 2: The learner will be able to list negative and preferred outcomes for older persons of waiting in hospital for a nursing home bed.
Although considerable concern about the use of hospitals by older persons who are waiting to be transferred to a nursing home is evident, few if any investigations have considered the impact on older people of waiting placement in hospital. Older people are often admitted to nursing homes from hospitals, after health care has failed to restore their health, as only about 40% of admissions are from the community. A phenomenological study was conducted to explore the lived experience of older patients waiting in hospital for placement in a nursing home. Although waiting placement in hospital is considered common in Canada, 12 months were required to acquire 9 volunteers in 2 large hospitals who met the criteria for inclusion. One semi-structured interview at a time and place of their choosing was the primary data collection method, although environmental observations including photographs of their living space augmented researcher understandings. Data from transcribed semi-structured interviews, field notes, and living space photographs were analyzed. Three themes were identified: (a) coming to a realization of this significant move; (b) waiting is boring and distressing, and (c) hospitals are not designed for waiting placement. Waiting placement clearly involved indefinite waiting, with a range of concerning negative physical, emotional, and cognitive impacts and implications of waiting in hospitals for placement revealed. Although this study needs replication, the findings should alert nurses, other healthcare professionals and other responsible persons to the many possible negative impacts of this wait in hospital; with remedies to address waiting placement care deficits subsequently planned and implemented.