Top-level managers' and politicians' worries about future care for older people with complex and acute illnesses: a Nordic study.

BACKGROUND

The growing aging population, with its associated complex needs and illnesses, will in the future become an even more important challenge for the Nordic countries.

AIM

The aim of the study was to describe and explore the perceptions and views of top-level managers and politicians in regard to an optimal future care for older people during the next decade.

DESIGN

The study has a qualitative, descriptive design.

METHODS

Top-level managers (n = 11) and politicians (n = 8) were interviewed in Sweden, Finland, Denmark and Norway in 2009. The data material was analysed through manifest and latent content analyses.

RESULTS

Future care should substantially focus on the individual needs and dignity of older people. The respondents also recommended a preventive perspective on future care. They anticipate that older people's needs will be complex, requiring nursing competence on an advanced level within home care and nursing homes, and point to the importance of leadership abilities and workplace image. Limited resources and the use of health technology will be dominant issues, entailing the need for open-mindedness to reorganise future care. The latent theme expressed was 'A creative willingness to act - but with an underlying worry about the future'.

CONCLUSIONS

The findings reveal a multifaceted scenario of optimal future care; older people will have significant, acute and complex needs but resources will be limited. In the near future, medical treatment and nursing care for older people at advanced and specialised levels within primary health care will be needed.

IMPLICATIONS FOR PRACTICE

To meet demands, a clear need exists for the advanced clinical competence of nurses. There is also a clear need to reorganise health care services for older people, develop the leadership abilities of nurse managers and make workplaces more attractive.