“To be seen” – older adults and their relatives’ care experiences given by a geriatric mobile team (GerMoT)

Abstract

Background The proportion of older people in the population has increased globally and has thus become a challenge in health and social care. There is good evidence that care based on comprehensive geriatric assessment (CGA) is superior to the usual care found in acute hospital settings; however, the evidence is scarcer in community-dwelling older people. This study is a secondary outcome of a randomized controlled trial of community-dwelling older people in which the intervention group (IG) received CGA-based care by a geriatric mobile geriatric team (GerMoT). The aim of this study is to obtain a better understanding, from the patients’ perspective, the experience of being a part of the IG for both the participants and their relatives. Methods Qualitative semistructured interviews of twenty-two community dwelling participants and eleven of their relatives were conducted using content analysis for interpretation. Results The main finding expressed by the participants and their relatives was in the form of feelings related to safety and security and being recognized. The participants found the care easily accessible, and that contacts could be taken according to needs by health care professionals who knew them. This is in accordance with person-centred care as recommended by the World Health Organisation (WHO) for older people in need of integrated care. Other positive aspects were recurrent health examinations and being given the time needed when seeking health care. Not all participants were positive as some found the information about the intervention to be unclear especially regarding whom to contact when in different situations. Conclusions CGA-based care of community-dwelling older people shows promising results as the participants in GerMoT found the care was giving a feeling of security and safety. They found the care easily accessible and that it was provided by health care professionals who knew them as a person and knew their health care problems. They found this to be in contrast to the usual care provided, but GerMoT care did not fulfill some people’s expectations.

Exploring stakeholders’ experiences of comprehensive geriatric assessment in the community and out-patient settings: a qualitative evidence synthesis

“…Four studies were conducted in both the Netherlands [ 30 – 33 ] and the United Kingdom [ 34 – 37 ]. Two studies were conducted in the United States [ 38 , 39 ], two were conducted in Germany [ 40 , 41 ], one was conducted in New Zealand [ 42 ], and one in Sweden [ 43 ]. Six studies employed a mixed-methods approach [ 31 , 34 , 35 , 37 , 38 , 40 ] while eight of the included studies employed exclusively qualitative methods [ 30 , 32 , 33 , 36 , 39 , 41 – 43 ].…”

“…Two studies were conducted in the United States [ 38 , 39 ], two were conducted in Germany [ 40 , 41 ], one was conducted in New Zealand [ 42 ], and one in Sweden [ 43 ]. Six studies employed a mixed-methods approach [ 31 , 34 , 35 , 37 , 38 , 40 ] while eight of the included studies employed exclusively qualitative methods [ 30 , 32 , 33 , 36 , 39 , 41 – 43 ]. The CGA was completed in the older person’s home in six studies [ 31 , 34 – 36 , 38 , 42 ], an out-patient setting in general practice in three studies [ 30 , 40 , 41 ], an out-patient setting in acute hospitals in three studies [ 32 , 33 , 39 ], the older persons home which then converted to virtual assessments due to the impact of COVID-19 in one study [ 37 ] and within the home and OPD in acute hospital setting in one study [ 43 ].…”

“…With regards to population, three studies were conducted with HCPs only [ 37 , 38 , 40 ], five with HCPs and older adults [ 31 , 33 , 35 , 39 , 42 ], two with HCPs, older adults and caregivers [ 32 , 34 ], one with older adults and caregivers [ 36 ] and three with older adults only [ 30 , 41 , 43 ]. One study did not report the number of participants involved [ 38 ].…”

“…The other 13 studies reported on the experiences of 155 HCPs, 194 older adults, 23 caregivers and 3 close relatives. Four studies identified older adults living with frailty for inclusion in the study [ 30 , 31 , 35 , 37 ], five studies identified older adults at risk of experiencing functional or health decline [ 34 , 36 , 39 , 42 , 43 ], while three studies included all community-dwelling older adults [ 38 , 40 , 41 ]. Two studies specifically explored participants experience of CGA for older adults living with kidney disease [ 32 , 33 ].…”

“…Home assessments had to be changed to remote (video/telephone due to COVID-19 restrictions) General practitioner Participating General practitioners received training on carrying out the assessment from the project lead, who also received training from a practice in Scotland Ericsson et al 2021. Sweden [ 43 ] “To be seen” – older adults and their relatives’ care experiences given by a geriatric mobile team (GerMoT) Community-dwelling older people aged ≥ 75 years who have had 3 or more visits to the emergency care unit within the past 18 months and have ≥ 3 different diagnoses Total sample N = 33. Older adults ( n = 22) Relatives/caregivers ( n = 11) In-home and OPD in acute hospital To obtain a better understanding, from the patients’ perspective, the experience of receiving CGA for both the participants and their relatives Qualitative.…”