TY - JOUR
T1 - Getting back to normal
T2 - A grounded theory study of function in post-hospitalized older adults
AU - Liebzeit, Daniel
AU - Bratzke, Lisa
AU - Boltz, Marie
AU - Purvis, Suzanne
AU - King, Barbara
N1 - Funding Information:
Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health [Award Number F31NR017104]; the 2017 Eckburg Fund Research Award from the School of Nursing, University of Wisconsin - Madison; and an OAA Advanced Fellowship in Geriatrics (William S. Middleton Memorial Veterans Hospital, Madison, WI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the U.S. Department of Veterans Affairs or the United States Government.
Funding Information:
Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health [Award Number F31NR017104]; the 2017 Eckburg Fund Research Award from the School of Nursing, University of Wisconsin – Madison; and an OAA Advanced Fellowship in Geriatrics (William S. Middleton Memorial Veterans Hospital, Madison, WI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the U.S. Department of Veterans Affairs or the United States Government.
Publisher Copyright:
© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.
PY - 2020/5/15
Y1 - 2020/5/15
N2 - Background and Objectives: The literature on transitions after hospitalization is based on a medicalized model focusing primarily on medication management and readmission, but little is known about the process older adults engage in to maintain their normal life posthealth event or how older adults define what the transition is. This grounded theory study aimed to describe how older adults understand and define a transition process, what actions they take based on their understanding, and what consequences they experience as they transition. Research Design and Methods: Adults aged 65 and older discharged from a large Midwestern teaching hospital (N = 14) were interviewed using in-depth one-on-one interviews. Data were analyzed using open, axial, and selective coding. Results: All participants described the process of transition as moving from a state of normal function to loss, and then working back to a normal state. A conceptual model was developed to illustrate the complexity of movement related to how older adults understand and manage the transition. All participants described starting out being normal until they experienced a major health event (acute or chronic illness). Losing normal involved experiencing a lower level of function both inside and outside the home. Working back to normal was accomplished by two different pathways: those “working to regain” focused on getting back to the level they were at prior to the major health event, whereas those “working to maintain” often involved redefining a new normal. The consequences of the two pathways were quite different, with those working to maintain describing several negative consequences. Discussion and Implications: This study provides a detailed understanding of how older adults transition and the complexity of that transition. Findings provide a foundation for broadening our understanding of function beyond typical activities of daily living and reveal a more complex transition process that can span months to years.
AB - Background and Objectives: The literature on transitions after hospitalization is based on a medicalized model focusing primarily on medication management and readmission, but little is known about the process older adults engage in to maintain their normal life posthealth event or how older adults define what the transition is. This grounded theory study aimed to describe how older adults understand and define a transition process, what actions they take based on their understanding, and what consequences they experience as they transition. Research Design and Methods: Adults aged 65 and older discharged from a large Midwestern teaching hospital (N = 14) were interviewed using in-depth one-on-one interviews. Data were analyzed using open, axial, and selective coding. Results: All participants described the process of transition as moving from a state of normal function to loss, and then working back to a normal state. A conceptual model was developed to illustrate the complexity of movement related to how older adults understand and manage the transition. All participants described starting out being normal until they experienced a major health event (acute or chronic illness). Losing normal involved experiencing a lower level of function both inside and outside the home. Working back to normal was accomplished by two different pathways: those “working to regain” focused on getting back to the level they were at prior to the major health event, whereas those “working to maintain” often involved redefining a new normal. The consequences of the two pathways were quite different, with those working to maintain describing several negative consequences. Discussion and Implications: This study provides a detailed understanding of how older adults transition and the complexity of that transition. Findings provide a foundation for broadening our understanding of function beyond typical activities of daily living and reveal a more complex transition process that can span months to years.
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U2 - 10.1093/geront/gnz057
DO - 10.1093/geront/gnz057
M3 - Article
C2 - 31087040
AN - SCOPUS:85070825717
SN - 0016-9013
VL - 60
SP - 704
EP - 714
JO - Gerontologist
JF - Gerontologist
IS - 4
ER -