title: Being in-between and lost in the discharge process--an excursus of two empirical studies of older persons', their relatives', and care professionals' experience.
abstract: The discharge process (DP) is full of well-known risks, and a comprehensive and well-executed DP is especially important for older people with multiple health problems and continuing care needs, as well as for their relatives. Few studies focus on the experiences with the DP by older people in need of home care nursing and their relatives. Therefore, the aim was to deepen the understanding of the DP as a phenomenon described by older people, their relatives, and care professionals. The method is an excursus of the findings of two previously published research studies. By using the Reflective Lifeworld Research approach, the empirical findings were further interpreted with lifeworld theory. The results describe the essential meaning of the phenomenon of DP in relation to healthcare needs. The illness and the DP can be viewed as a course of action where the familiar becomes unfamiliar for older people and their relatives, entailing an insecure future existence characterized by the experience of being in-between. The DP is marked by bodily and existential needs. The older persons and their relatives are lost in the hospital context and trying to influence life and adapt to life circumstances, while being relentlessly dependent on care professionals. Care professionals work from both an organizational and a medical approach. Disharmony and disagreement seem to arise easily among the professionals regarding the planning negatively affecting the patients and their relatives. More efforts are needed in the DP to empower older people and their relatives to go on with their life at home. The caring practice needs to more clearly meet and address the individual needs of older people and their relatives and their understanding of their illness. It needs to give them lifeworld and life goals to alleviate their suffering and to help them adjust to their new situation.
authors.affiliation: Department of Neurobiology, Care Science and Society, Centre for Family Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden. ing-britt.rydeman@sll.se
authors.forename: Ingbritt
authors.initials: I
authors.lastname: Rydeman
authors.forename: Lena
authors.initials: L
authors.lastname: Törnkvist
authors.forename: Lars
authors.initials: L
authors.lastname: Agreus
authors.forename: Karin
authors.initials: K
authors.lastname: Dahlberg
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D017028:Caregivers; D003266:Continuity of Patient Care / Q000592:standards*; D005190:Family; D006282:Health Personnel; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D010351:Patient Discharge / Q000592:standards*; D026684:Personal Autonomy; D011368:Professional-Family Relations