Finding a ‘new normal’ following acute illness: A qualitative study of influences on frail older people’s care preferences

SAGE Palliative Medicine & Chronic Care

This episode features Dr Simon Etkind (Cicely Saunders Institute, King’s College London, London, UK). To be person-centred, care should take into account individual preferences. Some influences on care preferences in older people have been described. These include the family and care context, individual response and illness-related factors. Older people living with frailty are at high risk of acute illness episodes; the influences on preferences in the context of frailty and recent acute illness have not been explored. Achieving normality, by ‘getting back to normal’ or ‘finding a new normal’ influences preferences in frail older people with recent acute illness, as participants seek care that will help them find this normality. Preferences are also influenced by the way people respond to changing health and care experiences. We propose a model of influences on care preferences in the context of recent acute illness. The influences described in this model can act as a guide for discussion and elicitation of current and future care preferences in this population. When addressing care preferences with patients and families, clinicians should discuss what may be an achievable normal for them within their social context. Prospective longitudinal study will allow exploration of influences on the stability of care preferences following acute illness. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/0269216318817706