title: Older people's perspectives on an elderly-friendly hospital environment: an exploratory study.
abstract: BACKGROUND
  Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people's perspectives on an "elderly-friendly" hospital.
  
  
  METHODS
  Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes.
  
  
  RESULTS
  Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people's health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services.
  
  
  CONCLUSIONS
  Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that focus on older people's health benefits and friendly services.
authors.affiliation: Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal.
authors.forename: Sushmita
authors.initials: S
authors.lastname: Karki
authors.affiliation: Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal ; Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Dharma Nand
authors.initials: DN
authors.lastname: Bhatta
authors.affiliation: Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal.
authors.forename: Umesh Raj
authors.initials: UR
authors.lastname: Aryal
keywords: advocacy; elderly-friendly hospital; hospital environment; older; policy