Older adults' experiences of hospital-to-home transitions in rural Sweden: a qualitative study

The transition from hospital to home represents a pivotal and potentially high-risk phase for older adults, especially within rural contexts where geographical remoteness, limited resources, and decentralized healthcare infrastructure amplify vulnerabilities. Existing literature offers limited insight into the experiences of rural older adults during this transitional process. Therefore, this study aimed to explore older adults' experiences of transitioning from hospital to home in rural settings and to describe how they felt during the process.

This qualitative study used open, unstructured interviews to explore older adults' experiences of hospital-to-home transitions in a rural region of northern Sweden. Nine older adults (aged 69-85) who had recently been discharged from somatic inpatient wards of a county hospital participated. In one interview, the spouse of one of them also participated. Data were analyzed using a six-phase Reflexive Thematic Analysis.

Older adults' hospital-to-home transitions were experienced as twofold, involving both a physical transition from hospital to home and an inner transition of self-image. Their experiences related to three interconnected dimensions: organizational, psychological, and social. The themes identified were "Knowing one's way through the healthcare system," "Understanding and managing one's thoughts and emotions," and "Feeling socially connected."

Care transitions for older adults in a rural context are complex and highly personal; therefore, healthcare professionals must thoroughly assess each individual's specific circumstances, including their psychological resources and social networks, during care planning.