Perceptions of Frail Older Adults on Contributing Factors Causing the Onset of Crises Leading to Hospital Admissions: A Qualitative Study.
Gercora Hoitinga, Janet Macneil-Vroomen, Daisy Kolk and 3 others
PMID 39670344WHAT IT FOUND
Frail older adults saw a fall, UTI or dizziness as the reason for the emergency department visit, but described months of unaddressed decline, stigma around frailty and delayed help-seeking.
Key findings
01Most participants linked the ED visit to a fall, urinary tract infection or dizziness 1-3 days earlier, but also described a 4-week window of triggering events such as medication changes, caregiver absence or infection.
02Nearly all participants did not see themselves as frail and described the label as stigmatising; family members told them they minimised problems and delayed medical care.
03Participants often consulted family or neighbours before seeking medical help, and this could delay an adequate response.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
Only 15 people were interviewed, and data saturation was reached after 8 interviews, so the themes may not represent other frail older adults. Participants were frail older adults living alone in metropolitan Amsterdam and admitted to an academic emergency department, so findings may not apply to rural areas or general hospitals. The interviews asked about events 6-9 months earlier, and the authors note recall bias; a recent health crisis may make earlier problems seem less important. This was a qualitative study of perceptions, not a test of any intervention, so it cannot show that monitoring, case management or education prevents admissions.
Declared interests
The authors declare no conflicts of interest. No funding statement is provided in the supplied text.
The easy way to misread this
Do not assume earlier monitoring or case management prevents admissions. The study only described perceptions in 15 frail older adults; it did not test any intervention.