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The trajectories of elderly people who are “unnecessarily” hospitalized: Being a key player at the end of one’s life?

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2020. Sujet(s) : Ressources en ligne : Abrégé : Certain hospitalizations of elderly people are described as “unnecessary” because they receive medical, paramedical, and social care that could be provided outside the hospital: at home or in other facilities more suited to their needs or situations. The PAGE study aims to understand the reasons behind these unnecessary hospitalizations of elderly people with mild to moderate cognitive impairment, and to describe the consequences of these care trajectories on the end of their lives. How can we reflect on, anticipate, and adjust their care needs according to their wishes? Seventeen semi-structured individual interviews were conducted with elderly people, as well as with their informal (n = 8) and formal (n = 14) caregivers. In order to follow their care trajectories, interviews were conducted in each different place where the elderly people stayed (first at the hospital, then in nursing homes, long-term care facilities, or at home) in the six months following their hospitalization. Unnecessary hospitalizations occur when the daily routine is no longer appropriate, forcing families or elderly people to make urgent decisions that go against their wishes and needs. On the other hand, these hospitalizations reveal a denial of the loss of functional autonomy among elderly people. Finally, our results show that, while elderly people experience losses through these care trajectories, discussions about the long term and decisions about the end of their life are postponed.
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Certain hospitalizations of elderly people are described as “unnecessary” because they receive medical, paramedical, and social care that could be provided outside the hospital: at home or in other facilities more suited to their needs or situations. The PAGE study aims to understand the reasons behind these unnecessary hospitalizations of elderly people with mild to moderate cognitive impairment, and to describe the consequences of these care trajectories on the end of their lives. How can we reflect on, anticipate, and adjust their care needs according to their wishes? Seventeen semi-structured individual interviews were conducted with elderly people, as well as with their informal (n = 8) and formal (n = 14) caregivers. In order to follow their care trajectories, interviews were conducted in each different place where the elderly people stayed (first at the hospital, then in nursing homes, long-term care facilities, or at home) in the six months following their hospitalization. Unnecessary hospitalizations occur when the daily routine is no longer appropriate, forcing families or elderly people to make urgent decisions that go against their wishes and needs. On the other hand, these hospitalizations reveal a denial of the loss of functional autonomy among elderly people. Finally, our results show that, while elderly people experience losses through these care trajectories, discussions about the long term and decisions about the end of their life are postponed.

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