title: 'It is a completely new world you step into.' How older clients and their representatives experience the operational access to Dutch long-term institutional care.
abstract: OBJECTIVE
  The access process is an important first step in the long-term institutional care for older people. Access can be seen as a concept consisting of three closely related dimensions: availability, affordability and acceptability (three A's). This study takes a new perspective by investigating how older clients experience the access process.
  
  
  METHODS
  Data were gathered through interviews with representatives of clients that were recently admitted in a long-term care facility, or if possible with clients themselves. A total of 33 respondents from 4 organizations that provide long-term institutional care were interviewed.
  
  
  RESULTS
  The first contact with the long-term care provider was made in several different ways. Finding a location nearby family was a common aim, which in urgent situations was not always feasible. Most respondents were satisfied about the process and felt taken care of personally. Yet, many respondents mention the lack of practical information and 'guidance' in the complexity of elder care. For acceptability, having a dedicated liaison in the organization was relevant.
  
  
  CONCLUSIONS
  The study revealed that the 3A model can be used to understand how older clients or their representatives experience the operational access process to long-term care. Especially the dimensions' availability and acceptability seemed to shape their experience.
authors.affiliation: Department of Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, The Netherlands; Surplus, Zevenbergen, The Netherlands. Electronic address: e.c.c.schipper@tilburguniversity.edu.
authors.forename: Lisette
authors.initials: L
authors.lastname: Schipper
authors.affiliation: Department of Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, The Netherlands. Electronic address: k.g.luijkx@tilburguniversity.edu.
authors.forename: Katrien G
authors.initials: KG
authors.lastname: Luijkx
authors.affiliation: Department of Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, The Netherlands; Department Organization and Strategy, Tilburg School of Economics and Management, Tilburg University, The Netherlands. Electronic address: b.r.meijboom@tilburguniversity.edu.
authors.forename: Bert R
authors.initials: BR
authors.lastname: Meijboom
authors.affiliation: Caphri, Department of Family Medicine and Department of Health Services Research, Maastricht University, The Netherlands. Electronic address: jos.schols@maastrichtuniversity.nl.
authors.forename: Jos M G A
authors.initials: JM
authors.lastname: Schols
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005190:Family / Q000523:psychology; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009735:Nursing Homes; D017060:Patient Satisfaction
keywords: Access to care; Long-term care; Nursing homes; Residential homes; The Netherlands