Understanding the psychosocial well-being of people older than 65 years during emergency department admissions: A qualitative analysis of patients' accounts of their experiences

Abstract

Objective

Little is known about the psychosocial care of older people presenting to the emergency department (ED), or whether their psychosocial well-being during and after an ED admission can be enhanced. People over the age of 65 years experiencing psychosocial distress and mental health concerns have higher rates of ED admission than those without. As part of a larger mixed-methods study investigating the relationships between older people's psychosocial well-being and emergency care, this study aimed to explore the experiences of older people in ED and their influence on patient psychosocial well-being.

Methods

Participants aged 65 years or older receiving care in a large Australian public hospital ED were invited to participate in a telephone interview soon after discharge. Interviews were audio recorded and transcribed. Transcripts were analysed thematically.

Results

Eleven people (five women) aged 68–87 years participated in semi-structured interviews. Analyses revealed three overarching themes: ‘interpersonal interactions’, ‘quality of care’ and ‘physical environment’. The theme ‘interpersonal interactions’ had two subthemes: ‘communication’ and ‘human contact’. The three subthemes of ‘quality of care’ were ‘appropriate care’, ‘psychological care’ and ‘unmet needs’. Physical environment referred to participant impressions of the ED setting.

Conclusions

We found that staff sensitivity in their interactions with patients and their efforts to promote patients' physical comfort and protect their privacy influenced the psychosocial well-being of older adults in the ED. Based on the findings, we present a set of recommendations for enhancing the psychosocial care of older adults during ED admission.