title: Suffering caused by care-elderly patients' experiences in community care.
abstract: BACKGROUND
  Growing old involves many changes in life and implies an increased risks of illness and different forms of disabilities. Life may change in a radical way when a person gets a disease like dementia or moves to a nursing home due to disabilities or needs. In both cases, it often leads to an increased dependency on care where the patient becomes exposed and vulnerable and thereby at a higher risk for experiencing different forms of suffering.
  
  
  OBJECTIVE
  The aim of this study was to elucidate and gain a deeper understanding of elderly patients' experiences of suffering in relation to community care in nursing homes and home care services.
  
  
  METHODS
  A lifeworld hermeneutical approach was used. Phenomenological interviews and conversations with an open approach were conducted and analysed with a focus on meanings.
  
  
  RESULTS
  The findings were presented in four main themes; an absence of the other in care, an absence of dialogues, a sense of alienation and a sense of insecurity. The findings in this study revealed that persons who were cared for in nursing homes and home care services sometimes were exposed to an unnecessary suffering. The suffering sometimes was caused by various caring actions, that is, unnecessary suffering. The suffering caused by care that aroused was due to caregiver's inability to be present, to show their face, and truly meet the patient.
  
  
  CONCLUSIONS
  Suffering from care increased the elderly patients' feelings of insecurity, loneliness, and alienation; this seemed to be the foundation for patients' experiences of being outside a human community. There was a lack of knowledge and understanding about the patient's lifeworld.
authors.affiliation: School of Life Sciences, University of Skövde, Skövde, Sweden; rune.svanström@his.se.
authors.forename: Rune
authors.initials: R
authors.lastname: Svanström
authors.forename: Annelie
authors.initials: A
authors.lastname: Johansson Sundler
authors.forename: Mia
authors.initials: M
authors.lastname: Berglund
authors.forename: Lars
authors.initials: L
authors.lastname: Westin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D003704:Dementia / Q000451:nursing / Q000523:psychology; D036262:Empirical Research; D005260:Female; D006699:Home Care Services; D006707:Homes for the Aged; D006801:Humans; D008132:Loneliness / Q000523:psychology; D008134:Long-Term Care / Q000523:psychology; D008297:Male; D009735:Nursing Homes; D005791:Patient Care / Q000523:psychology*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012918:Social Alienation / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D013548:Sweden
keywords: Elderly; care; dementia; lifeworld; patient experiences; suffering