Losing connections and receiving support to reconnect: experiences of frail older people within care programmes implemented in primary care settings

Abstract

Aims and objectives: The objective of this study was to evaluate whether care provided in the care programmes matched the needs of older people.

Background: Care programmes were implemented in primary-care settings in the Netherlands to identify frail older people and to prevent further deterioration of health.

Design and methods: In total, 23 older people participated in in-depth interviews. Within this study, three older people participated as co-researchers; they gathered and analysed the data together with the academic researchers. Content analysis was used to analyse the data.

Results: Two categories emerged from the data: 'Losing connections' and 'Receiving support to reconnect.' 'Losing connections' reflects the needs of older people and 'Receiving support to reconnect' reflects their experience and the appreciated aspects of the provided care. A relationship of trust with the practice nurse (PN) appeared to be an important aspect of care, as it fostered the sharing of feelings and issues other than physical or medical problems that could not be shared with the general practitioner. The PNs are experienced as connectors, who help to restore feelings of connectedness and older peoples' access to resources in the community.

Conclusions: The relationship with the PN was experienced as valuable because of the feelings of 'connectedness' it created. Through this connectedness, older people could discuss feelings of loneliness, depression and frustration in receiving and acquiring the appropriate resources and services with the PNs. Furthermore, the relationship with the PN helped the older people to gain access to other health professionals and services.

Implications for practice: The results imply that care for frail older people should include an awareness of the importance of the trusting relationship. Nurses can play a vital role in creating a trusting relationship and are able to bridge the gap between older people and other professionals and services.

Keywords: care programmes; caring relationship; frail older people; frailty; home visits; practice nurses.