Navigating the Health Care System: Movement and Meaning for Older People with Dementia

Abstract

Older people with dementia are significant users of both long-term care and acute care services. The transitions between these services are not always smooth and very little is known about the meaning that such transitions have for people with dementia. This study aimed to explore the journeys of residential aged care facility (RACF) residents with dementia as they transition through the acute care system, and to investigate the system features and continuity of care (COC) issues that serve to shape the meanings that these transitions have for these people. The study addresses the following two research questions: 1. What meanings do people with dementia construct from their multiple transition experiences? 2. What are the factors that affect COC, and therefore, have an impact on the transition experiences of people with dementia through the system? This study was guided by a critical social constructionism paradigm and employed a whole-system design and narrative methods. This approach enabled the researcher to explore ‘the person in the system’. Data were collected through mixed methods including transfer tracking, formal interviews, observations, chart audit, and document review. Data analysis was undertaken using a narrative analysis approach that acknowledged people’s ability to construct their own meaning within particular contexts.