Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK.
School of Health Sciences, University of East Anglia, Norwich, UK.
Fam Pract. 2019 Nov 18;36(6):778-784. doi: 10.1093/fampra/cmz014.
It can be challenging for general practitioners to support their oldest old patients through the complex process of relocation.
To provide a typology of the experiences of moving in very old age that is clinically useful for practitioners navigating very old people's relocation.
Qualitative analysis of data from a mixed-methods UK population-based longitudinal study, Cambridge City over-75s Cohort (CC75C), from Year 21 follow-up onwards. Interviews with participants aged ≥95 years old and proxy informants (Year 21: 44/48, 92%, subsequent attrition all deaths). Thematic analysis of qualitative data available from 26/32 participants who moved before they died.
Individuals who moved voluntarily in with family experienced gratitude, and those who moved into sheltered house or care homes voluntarily had no regrets. One voluntary move into care was experienced with regret, loss and increased isolation as it severed life-long community ties. Regret and loss were key experiences for those making involuntary moves into care, but acceptance, relief and appreciation of increased company were also observed. The key experience of family members was trauma. Establishing connections with people or place ahead of moving, for example through previous respite care, eased moving. A checklist for practitioners based on the resulting typology of relocation is proposed.
Most of the sample moved into residential care. This study highlights the importance of connections to locality, people and place along with good family relationships as the key facilitators of a healthy transition into care for the oldest old. The proposed checklist may have clinical utility.
全科医生在帮助最年长的老年患者完成复杂的搬迁过程时可能会面临挑战。
为临床医生在为非常年长的人进行搬迁时提供一种有用的经验分类，以帮助他们了解老年人的搬迁经历。
对英国基于人群的纵向研究——剑桥市 75 岁以上人群队列（CC75C）的混合方法数据进行定性分析，研究对象为年龄≥95 岁的参与者及其代理人（第 21 年：44/48，92%，随后的所有参与者均去世）。对 26/32 名在去世前搬迁的参与者进行了访谈，他们提供了可用的定性数据。
自愿与家人同住的人感到感激，自愿搬到庇护所或养老院的人没有遗憾。有一个自愿进入养老院的案例，由于断绝了终身的社区联系，导致了遗憾、失落和增加的孤立感。对于那些被迫进入养老院的人来说，遗憾和失落是主要的经历，但也有接受、解脱和对更多陪伴的感激。家庭成员的主要经历是创伤。在搬迁之前与人和地方建立联系，例如通过以前的临时护理，这可以减轻搬迁的压力。根据搬迁的经验分类提出了一份针对从业者的清单。
大多数样本都搬到了养老院。本研究强调了与当地、人与地方的联系以及良好的家庭关系的重要性，这些是最年长的老年人健康进入养老院的关键促进因素。建议的清单可能具有临床实用价值。
