The older patient's experience of encountering professional carers and close relatives during an acute confusional state: An interview study

Background: Acute confusional state (ACS) is a common and difficult condition among older patients with a variety of opinions about how to act when encountering patients with ACS. Few studies to our knowledge have been found exploring the encounter from the perspective of older patients and their experiences. Objectives: The aim of this study was to understand the experiences of older patients with ACS when encountering professional carers and close relatives. Design: In order to understand older patients' experiences of encounters during their ACS a latent qualitative content analysis was used. Settings: The data collection took place at two geriatric wards in an emergency hospital in a metropolitan area. Participants: The inclusion criteria included being aged 65 years or older and having suffered from ACS, according to the DSM-IV criteria, and having regained lucidity. Participants were being cared for at one of two geriatric wards. Patients diagnosed with dementia were excluded. About 150 patients were screened, 67 patients fulfilled the inclusion criteria and seven patients were included in the study, four females and three males, aged between 79 and 98 years. Methods: Data were collected by interviews. Results: Three themes were found, namely; 'Feeling lonely within the perceived reality of ACS', with three sub-themes: the unequal encounter, keeping a distance and being an outsider; 'striving towards understanding' with two sub-themes: searching for answers and it takes time to understand; and 'feelings of participation in the encounter' with two sub-themes: a mutual understanding and feeling safe and supported. Conclusions: Within the encounter the older patients with ACS are searching for answers to what is happening and why. The patients feel dependent on the persons they encounter and their willingness to understand and communicate. The patients also feel lonely, unnecessarily questioned and untrustworthy; but they can also feel safe, trusted and understood. (C) 2008 Elsevier Ltd. All rights reserved.