Care experiences of older people with mental health needs and their families in emergency medical services settings

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Abstract

Background: There are challenges to person-centred care provision in Emergency Medical Services (EMS) settings. The environment is often busy and noisy which can influence the experience of older people and their carer/partners when they attend emergency departments. Older people with mental health needs are a vulnerable group of people who are at risk of not having their needs met in acute care settings. This is due to complex presentations and increased pressures on the EMS system. Aim: The aim of the paper was to explore the care experience of older people with mental health needs and their carer/partners in pre-hospital and in-hospital Emergency Medical Services settings. Method: This study used an interpretive qualitative approach incorporating in-depth, individual interviews to gather information on the experience of the older person with mental health needs and carers/partners. Data were analysed using Braun and Clarke's (2006) thematic analysis. Results: Fifteen individual interviews were carried out with older people with mental health needs (n = 10) and with carers/partners (n = 5). Six themes on ‘Getting there, getting in and getting out’, ‘Seeing the person’, ‘Perceptions and experiences of the pre-hospital and Emergency Department (ED)’, ‘The effects of the experience on personal well-being’, ‘Older person/carer/partner perceptions and experiences of the EMS staff’ and ‘Making it better’ emerged from the data. Conclusions: The results suggest that previous experiences with the emergency care system influence the way older people with mental health needs and their carers make decisions on current and future care needs. Negative experiences can be influenced by the layout and organisation of the ED. Participants remain reluctant to discuss or disclose their diagnosis in the Emergency Medical Services setting due to a perceived stigma. Health and social care systems and services need to undergo transformations to ensure that all people who access services are treated fairly and effectively.

Original languageEnglish
Article numbere12500
Number of pages12
JournalInternational Journal of Older People Nursing
Early online date26 Aug 2022
DOIs
Publication statusPublished online - 26 Aug 2022

Bibliographical note

Funding Information:
We would like to acknowledge the help and guidance provided by the staff of the Honest Broker Service (HBS) within the Business Services Organisation Northern Ireland (BSO), particularly the support of Siobhan Morgan throughout the process and latterly, Gary Ewing and Neil Marsden. The HBS is funded by the BSO and the Department of Health, Social Services and Public Safety for Northern Ireland (DHSSPSNI). We are responsible for the interpretation of the data, and any views or opinions presented are solely ours and do not necessarily represent those of the BSO.

Publisher Copyright:
© 2022 The Authors. International Journal of Older People Nursing published by John Wiley & Sons Ltd.

Keywords

  • emergency Department
  • emergency medical services
  • experiences
  • families
  • mental health
  • older people
  • prehospital

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