Poor social support provided within health care settings may reduce patients' ability to manage disease. The presence of family members in emergency department (ED) may reduce the patient's need for health care and social services utilization. The aim of the study was to describe the social support received by family in the ED. A cross-sectional empirical study design was used. Convenience sample of 111 family members of home discharged older patients and of 93 nurses were recruited. The study was conducted at four Estonian hospitals. Data were collected by using social support scale of the Family Functioning, Health and Social Support (FAFHES). Family members and nurses both considered the social support available in EDs to be moderate. Nurses believed they provided higher levels of social support than the family members stated the family received. The differences were statistically significant. The older a nurse was, the less reinforcement, feedback, and affecting others for finding solutions was offered. A greater number of nurses working in the ED resulted in less social support. This study found differences of views between family members of older patients and nurses regarding the level of social support of the family. Nursing care provided in ED should be developed to be more supportive. To ensure more family-centred approach when providing nursing care, the administrative staff needs to consider whether an adequate number of nurses are working in the ED. The social support scale used was found to be applicable in ED environments.

The functioning of families in emergency departments (EDs) encompasses the level at which the families of older patients perform as a whole during the ED stay. Currently, little is known about how the families of older patients function in EDs. In this study, family functioning included the subareas of family strengths, structural factors and relationships both inside and outside the family. The study aimed to describe family functioning in EDs as evaluated by both the family members (n = 111) of older patients and nurses (n = 93). The data were collected from four Estonian hospitals, and the scale used was the Family Functioning, Health and Social Support scale. The results showed that both the family members and nurses evaluated family functioning and all its subareas as being moderate. Family structural factors were found to be associated with the family members' social status. The scores in the subareas were higher when older patients had received help from family members before the ED visit. The family members and nurses differed significantly in the scores they gave for family functioning in general and for all the subareas. No association was found between family functioning as rated by nurses and the families' demographic characteristics. These results suggest that nurses should pay more attention to family functioning in general and to the structural factors within the family, including internal relationships, while older patients are in the ED. Comprehensive knowledge about how families function during an ED stay may help nurses to better meet the needs of older patients and their families and help them to prepare families to provide aftercare at home. Our findings support the idea that healthcare organisation and delivery should be more family centred.

Older patients quite often arrive in an emergency department (ED) with a family member, but little is known about the family member's health evaluated in ED. The aim of this study was to describe family health in EDs evaluated by family members and nurses. Data were collected from Estonian hospital EDs from 111 family members of older patients and from 93 nurses. Family health in EDs was evaluated as being at a moderate level. Family members reported that family health was better when older patients lived with the family. The more time the family spent in the ED, the worse the health-related activities were. Nurses reported that cardiovascular problems in older patients who presented in EDs disturbed the values of family health. We conclude that ED nurses should recognize the level of family health, in order to ensure that the family will be able to cope at home. Family health in EDs should be reviewed over time to help nurses meet the required needs of the family.