title: The Untold Story of Being Designated an Alternate Level of Care Patient.
abstract: BACKGROUND
  Much of the research and policy reports on Alternate Level of Care (ALC) in Canada have focused on the impact ALC has on acute care services. To date, the experiences and opinions of those who must wait in hospital for alternate services have been largely absent from discussions.
  
  
  METHODS
  A qualitative study was conducted with patients and families designated as ALC in one urban and two rural hospitals in Atlantic Canada. Data were analyzed using content analysis.
  
  
  RESULTS
  Three themes emerged from the data: a perception of normalcy, being old but not sick and anticipating relocation to another facility.
  
  
  CONCLUSIONS
  ALC is an important issue for patients and their families. Policy directives aimed at addressing the causes and impacts of ALC, identification and provision of appropriate supportive care in the community and sensitivity to the impact of ALC for individuals designated as ALC are needed.
authors.affiliation: Professor, Department of Nursing & Health Sciences, University of New Brunswick, Saint John, NB.
authors.forename: Rose
authors.initials: R
authors.lastname: McCloskey
authors.affiliation: Associate Professor of Medicine, Dalhousie University, Geriatrician Horizon Health Network, Saint John, NB.
authors.forename: Pamela
authors.initials: P
authors.lastname: Jarrett
authors.affiliation: Assistant Professor, Department of Computer Science & Applied Statistics, University of New Brunswick, Saint John, NB.
authors.forename: Connie
authors.initials: C
authors.lastname: Stewart
mesh_terms: D000369:Aged, 80 and over; D001294:Attitude to Health; D005190:Family / Q000523:psychology*; D005260:Female; D016330:Frail Elderly / Q000523:psychology* / Q000706:statistics & numerical data; D006291:Health Policy; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006707:Homes for the Aged / Q000600:supply & distribution; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D009509:New Brunswick; D009735:Nursing Homes / Q000600:supply & distribution; D010360:Patient Transfer / Q000191:economics / Q000592:standards* / Q000639:trends; D010361:Patients / Q000523:psychology*; D036301:Qualitative Research; D059039:Standard of Care / Q000145:classification* / Q000191:economics / Q000639:trends; D013222:State Medicine / Q000191:economics / Q000458:organization & administration / Q000639:trends; D013997:Time Factors; D014850:Waiting Lists