title: 'They never talked to me about... ': Perspectives on aged care resident transfer to emergency departments.
abstract: OBJECTIVE
  To explore perspectives of three groups concerning transfers from aged care facilities to emergency departments. We sought to reveal factors influencing transfer decisions; how active each group was in making decisions; and to what extent groups ceded decision-making to others.
  
  
  METHODS
  Semi-structured interviews of 11 residents, 14 relatives and 17 staff with content analysis of interview transcripts.
  
  
  RESULTS
  The three groups substantially differed in their involvement with initiating, and attitudes towards, transfer. Residents were least likely to be involved in the decision, yet most likely to support transfer. Staff felt conflicted between their desire to provide optimal treatment for one ill resident, and their obligations to other residents under care. Staff perspectives were largely consistent with published data, but we describe new results for other informant groups.
  
  
  CONCLUSIONS
  Group expectations and preferences differ substantially. Service delivery to meet all preferences presents a challenge for health service design.
authors.affiliation: Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research, Perth, Western Australia, Australia.|School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Western Australia, Australia.|School of Public Health, Sydney University, Sydney, New South Wales, Australia.
authors.forename: Glenn
authors.initials: G
authors.lastname: Arendts
authors.affiliation: School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Aurora
authors.initials: A
authors.lastname: Popescu
authors.affiliation: School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Denise
authors.initials: D
authors.lastname: Howting
authors.affiliation: School of Public Health, Sydney University, Sydney, New South Wales, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Quine
authors.affiliation: School of Public Health, Sydney University, Sydney, New South Wales, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Howard
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001291:Attitude of Health Personnel; D002755:Choice Behavior; D003142:Communication; D003299:Cooperative Behavior; D004636:Emergency Service, Hospital; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006707:Homes for the Aged; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D008297:Male; D009723:Nurse-Patient Relations; D009735:Nursing Homes; D009740:Nursing Staff / Q000523:psychology*; D010358:Patient Participation; D010360:Patient Transfer; D011368:Professional-Family Relations; D035862:Vulnerable Populations / Q000523:psychology
keywords: emergency medicine; frail elderly; patient transfer; qualitative research; residential facilities