Exploring the lived experience of both the provider and the receivers of an Intentional Compassionate Communication Intervention (ICCI) for older people in an Accident and Emergency Department.

Abstract

Background Attending an Accident and Emergency (A&E) hospital department can be a stressful experience for older people. In 2016, to try and improve older people’s experience in A&E, an Intentional Compassionate Communication Intervention (ICCI) was developed by a hospital in Southern England to enhance the delivery of compassionate care. The ICCI comprised proactive communication-focused support targeted at older people, particularly those who were alone. Little is known about this intervention and about the experience of those receiving and providing it. Aim The purpose of this study was to explore the lived experience of older patients who received the ICCI in A&E and the lived experience of the member of staff who delivered the ICCI. Method Interpretative Phenomenological Analysis (IPA) was used to carry out one-to-one, semi-structured, in-person interviews with eight individuals over 65 years old who were admitted for any reason to the hospital via A&E, presented either alone or confused or with a diagnosis of dementia, received the ICCI while in A&E, were referred to the Dementia Care Team and were able to give informed consent. Four online IPA semi- structured interviews were carried out with the ICCI practitioner. Interviews were audio recorded and transcribed verbatim. The data were analysed thematically following IPA guidelines. Findings There were four main themes from the older person interviews in their experience of A&E: Helplessness, Uncertainty, Unpleasant Sensations, and a Sense of Safety. There were three main themes from the interviews with the ICCI practitioner: Navigating the Unknown, Bringing Together/Connect, and A Values-Based Practice. When bringing together the two sets of findings, three important concepts emerged: The Unknown (and the fear of it), Disconnection (and the sense of general lack of safety it prompted) and The Importance of Effective Communication. These concepts represented the threads weaving the two sets of findings together, allowing for new meaning to be made, and new knowledge to emerge. Conclusion Exploring the lived experience of older people in A&E and the ICCI practitioner has shown how this intervention can humanise the experience of being in A&E (i.e. allowing people to feel seen, connected, safer).