New thesis on older people’s hospital care

How can we avoid that older persons are hospitalised unnecessarily? And what drives many older persons to seek hospital treatment although they have access to home care? These are some of the questions, to which Jenny Hallgren seeks answers in her doctoral thesis in gerontology.

On 17 June Jenny Hallgren successfully defended her doctoral thesis SHOULD I STAY OR SHOULD I GO – Factors associated with hospitalization risk among older persons in Sweden at the School of Health and Welfare, Jönköping University. Among other things, the thesis investigates risk factors for older people to be hospitalised.

Since earlier, it is known that hospital treatment may involve a serious risk for older people. In the hospital environment their risk of being affected by infections, disorder and falling accidents is increased. What has been less known is what factors lead to older persons in Sweden being hospitalised.

“During my years as a clinically active nurse I met many older persons, who had turned to hospitals for diseases that actually do not require hospital care, but could have been handled by primary care or home health care. I realised that there is a need for knowledge that could prevent older persons from being hospitalised unnecessarily”, says Jenny Hallgren.

Therefore, one of the purposes with Jenny Hallgren’s thesis has been to study what risk factors there are for older people in Sweden, both living at home or in special accommodations, to be hospitalised.

“The risk factors turned out to be different depending on whether the older person lives at home or in a special accommodation. For persons in special accommodations the risk factors were for example if the person has several diseases or medicines, or if he or she has experienced a fall accident. For those living in ordinary housing it was instead issues like marital status and social factors”, says Jenny Hallgren.

The thesis also shows that many older persons, who already have home health care, still choose to seek hospital care. The reason for that is that they have a great confidence in the care and competence that they think hospitals have.

Another purpose has been to investigate if hospitalisation has an impact on the cognitive development of the older people. The thesis shows that middle-aged and older people, who have been hospitalised, have a faster deterioration of different cognitive functions than persons who have not been hospitalised.

“We observed a particularly fast deterioration of the spatial ability and the general cognitive ability. The spatial aspect concerns our ability to perceive the world around us and influences how well we can orientate ourselves and find our way around in different environments”, Jenny Hallgren explains.

Why then is this research important? According to Jenny Hallgren, it is important to be able to identify what persons that are at high risk of being hospitalised, so that they can be offered the right care at the right level, for example primary care instead of hospital care. That way the risk decreases that persons not really in need of hospital care seek this kind of health care because they have not been offered the proper care.

“Our hopes are that the new knowledge from the thesis will be usable for targeted efforts for people with an increased risk of being hospitalised, but also that it may be a support for hospital personnel who meet older people with an increased risk of cognitive deterioration”, Jenny Hallgren concludes.

Read the thesis on DIVA (Digitala Vetenskapliga Arkivet) External link, opens in new window.