Entrusting life to professionals: A phenomenological hermeneutical study of older persons' participation in prehospital emergency care involving municipal home care and ambulance services.

Abstract

Participation in care is considered to promote safe and qualitative care. Care-dependent older persons ageing in place have increased emergency care needs, which initiate inter-organisational collaboration involving municipal home care and ambulance services. Previous research concludes that uncertainties exist regarding what participation in care means in clinical practice, which necessitates the need to illuminate the phenomenon for older persons in critical life situations. This study aimed to illuminate meanings of participation in prehospital emergency care from the perspective of care-dependent older persons experiencing acute illness at home. This study has a qualitative design with a lifeworld approach. A phenomenological hermeneutical method was used to analyse transcribed telephone interviews with eleven care-dependent persons aged 70-93 years. Care-dependent older persons' participation in prehospital emergency care means 'Entrusting life to professional caregivers' when being in helpless solitude and existentially unsafe, which emphasises a deepened interpersonal dependence. Meanings of participation in care from the perspective of older persons involve Being reassured in togetherness, Being pliant in trust of emergency expertise, Being enabled through the agency of professional caregivers, and Encountering readiness in the emergency care chain. Care-dependent older persons' participation in prehospital emergency care is existential and involves interpersonal dependence. Togetherness brings reassurance, safety and opportunity for emotional rest while accessing the professional caregivers' power, competence and abilities which provide opportunities for existence and movement towards well-being and continued living. Prehospital emergency care from the perspective of care-dependent older persons transcends organisational boundaries and includes the municipal mobile safety alarm service. The involved municipal and regional organisations need to provide support by implementing lifeworld-led care models and care alternatives that enable professionals to recognise the existential dimension of participation in care.