ArticleBMC geriatrics2026
Older adults with advanced chronic illness and emergency department care: the hermeneutic stories of Bill, Edie and Nicole.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
backgroundOlder adults are living longer, often with multiple health conditions including frailty, and seek care in the Emergency Department (ED) proportionately more than younger adults. Increasing demand for care requires adaptation of service models across the health system as well as strategies within the ED itself. The lived experience of older adults with advanced chronic illnesses and/or frailty accessing EDs is little understood. We aimed to illuminate these experiences to identify areas for care improvement.
methodsOne local health district (population > 1 million) in Sydney, Australia. Qualitative interviews with older adults (≥ 65 years), who were receiving support in the community or who were residents of care homes and had attended one of three EDs in the previous 12 months, or their informal carers. Hermeneutic phenomenology was used to analyse the data and present findings within the context of human life rather than the boundedness of the ED.
resultsTwelve interviews were conducted: seven older adults, three carers, and two older adult and carer dyads. The hermeneutic stories of Bill and Edie, constructed from collective older adult interviews, illustrate how older adults with increasing dependence on the care of others eventually acquiesce to a system that is fragmented, inflexible, and population- and process-focussed, rather than person-oriented. Nicole's story illustrates carer distress in seeing older adults as passive recipients of care, and frustration in not being able to adequately represent them.
conclusionsThe ED becomes a principal provider of care for older adults with advanced chronic illnesses and frailty when they are at their most weak. Narratives of acquiescence, where older adults yield to authority or pressure or limit their agency as a choice, are a novel finding in health services research, Earlier identification of advancing illness, connection with support services, sensitivity to the changing preferences of older adults, and design for older adults' needs in ED must be supported by aligned policy and resources that strengthen community care and promote continuity in life.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.