Background: Care-dependent older persons in Sweden are encouraged to remain living at home in assistance of municipal home care, making older persons´ homes a growing arena for emergency care. The home care organization does not provide emergency care, and therefore depend on regional emergency medical services (EMS). The involvement of two organizations accentuates the older persons´ participation in care, to promote health, well-being and safety.
Aim: To elucidate older persons´ participation in care that involve municipal care personnel and emergency medical services.
Method: Register data from the ambulance services were explored using descriptive and analytical statistics. Qualitative data were collected by individual interviewing adhering to critical incident technique and phenomenological hermeneutics.
Results: Aspects of participation were disclosed in relation to welfare organizations and interpersonal relations. Quantitative results indicated that older adults were more likely to receive lower priority levels compared with the adult population in emergencies involving ambulance response. Qualitative results displayed how municipal care personnel were subjected to the attitude and priority assessment of the EMS, affecting their ability to provide adequate care. The welfare organizations involved were not adapted to the complex needs of care-dependent older persons, and consequently the older persons were hindered to access and partake in societal welfare on equal terms. Municipal care personnel acted as the older persons´ representatives in emergencies, enabling active participation in care.
Conclusion and implications: Lack of organizational flexibility and inter-professional collaboration negatively affect older persons´ ability to influence care. To ensure safe and adequate care alternatives aligned to the needs of older persons living in dependence at home, welfare organizations need to acknowledge emergencies as a natural part of older persons´ lives and adapt services accordingly. The EMS need to consider the older persons´ whole life situation in care assessments, and respect the perspectives of care personnel involved.