Early planning: A qualitative study on the experiences of older adults and involved decision-makers planning for care transitions in Scotland

PhD Project – Lucy Halamova

With the increasing number of older adults in the UK needing some level of care, it is important to understand the processes that happen as older adults need to make a transition to various care facilities. One key part of this is planning. Being able to plan for care transitions has been shown as helpful to older adults as well as their carers [1]. On the flip side, not having plans in place can lead to tough emotional and practical challenges during these transitions [2].

The absence of planning not only complicates transitions but also introduces an additional challenge by potentially excluding older adults from decision-making. Studies show that older adults, especially those who are very old, frail, or have dementia, are often excluded from decision-making [3, 4, 5]. In contrast, older adults with milder care needs tend to be involved more [6]. So, it seems that planning early, when older adults are more likely and able to be involved in decisions, would be helpful. To do this well, it's important to hear from older adults who've been through this transition as well as those involved in the decision-making process.

In this study, we will be conducting semi-structured interviews with three core stakeholder groups: Older adults who are residents of a care home (by ‘care home’ we mean any care facility with on-site carers or nursing staff), family/friend carers who were actively involved in the decision to move an older adult to a care home, and professionals who were also part of that decision-making process.

This qualitative study is a stage 2 of a larger project, which started with stage 1 literature review in my Master’s year (MRes in Psychology) and will finish with implementation of the findings (stage 3). We will know more about how to usefully implement our findings from stage 2 once the interviews are analysed and we can further discuss the findings with the core groups. 

1. S. Gilbert, E. Amella, B. Edlund, and L. Nemeth, “Making the move: A mixed research integrative review,” Healthcare (Switzerland), vol. 3, no. 3, pp. 757–774, Sep. 2015, doi: 10.3390/healthcare3030757.
2. S. A. Wilson, “The transition to nursing home life: A comparison of planned and unplanned admissions,” J Adv Nurs, vol. 26, no. 5, pp. 864–871, 1997, doi: 10.1046/j.1365-2648.1997.00636.x.
3. A. T. Larsson and J. H. Österholm, “How are decisions on care services for people with dementia made and experienced? A systematic review and qualitative synthesis of recent empirical findings,” Int Psychogeriatr, vol. 26, no. 11, pp. 1849–1862, 2014, doi: 10.1017/S104161021400132X.
4. K. Samsi, L. Cole, and J. Manthorpe, “‘The time has come’: Reflections on the ‘tipping point’ in deciding on a care home move,” Aging Ment Health, vol. 26, no. 9, pp. 1855–1861, 2022, doi: 10.1080/13607863.2021.1947963.
5. F. Scheibl, M. Farquhar, J. Buck, S. Barclay, C. Brayne, and J. Fleming, “When Frail Older People Relocate in Very Old Age, Who Makes the Decision?,” Innov Aging, vol. 3, no. 4, Aug. 2019, doi: 10.1093/geroni/igz030.
6. A. K. Stevens, H. Raphael, and S. M. Green, “A qualitative study of older people with minimal care needs experiences of their admission to a nursing home with Registered Nurse care,” Qual Ageing Older Adults, vol. 16, no. 2, pp. 94–105, Jun. 2015, doi: 10.1108/QAOA-09-2014-0020.

Contacts

• Lucy Halamova; l.halamova.23@abdn.ac.uk

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