From home care to care home: a phenomenological case study approach to examining the transition of older people to long-term care in Spain.

BACKGROUND AND AIMS: It has been the tradition in Spain until recently for families to take care of their own older relatives, but this is now changing, especially in urban areas where caring roles are also shifting. This study aims to examine the Spanish care transitions of older people moving from being traditionally a family-centred and gender-based cultural phenomenon to one that is moving gradually into professional care settings.
METHOD: A phenomenological case study approach was adopted, involving 15 cases exemplifying the care experience in typical primary care settings in one region of Spain, and examined how the transition from home care is happening. In-depth interviews with older people and carers with lived experience regarding the phenomenon took place.
RESULTS: Seven themes were identified portraying the current picture of the phenomenon, evidencing that care of older people is still culturally assumed as family-centred care and a gender-based responsibility, care homes have a negative social image, there are differences between rural and urban areas, there is a lack of training for professional and family carers, and family income and dependency level accelerate the transition.
CONCLUSIONS: This study revealed a lack of care services for older people in Spain, inconsistencies in service provision, as well as a lack of professional and non-professional training.