Identifying the facilitators and barriers of a healthy transition for adult children when an older parent is transferred to a nursing home: a narrative approach.

Abstract

Background: As the health of an older parent deteriorates, their transfer to a nursing home becomes inevitable to ensure that they receive safe and sufficient care, with the decision to transfer often being made and implemented within a matter of days. Family caregivers such as adult children remain actively involved in providing care after their parent's transfer to a nursing home, and are often described as an 'invisible workforce'. However, the impact of this situation on the health and well-being of adult children is rarely acknowledged. This study aimed to characterize the transition experiences of adult children during the weeks after their older parent's transfer to a nursing home, which is referred to as post-transition phase.

Methods: This research study formed part of a larger qualitative project that had a narrative, longitudinal, prospective design. We conducted 22 narrative interviews with 8 adult children of older parents on 3 occasions in 2022. Narrative analysis was used to structure and systemize the generated data.

Results: The findings are presented as two narratives of one daughter ('Susan') and one son ('Phillip') that exemplify common characteristics shared by all of the participants. They illustrate the facilitators and barriers of a healthy transition-defined as a positive and successful transition outcome-during the complex post-transition phase. Although sharing similar contextual circumstances, their narratives diverge with Phillip's account conveying a sense of calm and relief, while Susan's narrative reflects stress and tension. These exemplar narratives of adult children highlight how personal, organizational and social factors both facilitate and hinder a healthy transition.

Conclusions: The transfer of an older parent to a nursing home is often emotionally challenging for adult children. Healthcare personnel can help reduce the burden during the transition by supporting role mastery, subjective well‑being and well-being of relationships. Promoting the well‑being of adult children may have positive implications for their older parents as well as the healthcare services and society as a whole.