Participant or bystander? : Explaining the nature of older people's participation in the acute hospital discharge process in Ireland

Abstract

Discharge from acute hospital can represent a major life transition for older people with complex or chronic illnesses. Their participation in decision-making about future care and its location is essential to their human rights, since these decisions affect the rest of their lives. This is particularly pertinent in the current climate of bed shortages in acute hospitals and the subsequent emphasis on patient throughput. The purpose of this study was to explain the nature of older people's participation in the acute hospital discharge process in Ireland by locating the structures and mechanisms that shape older people's participation. Whilst research in this area has been carried out in other countries, there was a limited body of knowledge on older people's participation in the discharge process within an Irish context. Previous research indicated that older people's experiences of discharge planning vary and was related to factors at both a macro and micro level. These studies were mainly exploratory and did not offer an explanation for the observations made. Hence the guiding question for this research was 'how can the nature of older people's participation in the discharge process be explained?