Table 2 Extracts from the interview analysis process

Prerequisites for patient participation

Patient treatment and care

Necessary treatment of the patient

Routine treatment and care during hospital admission

We observe the patient’s vital functions to provide correct treatment and care. (ambulance worker)

Take care of vital functions

We are not forcing the patients, but we have to do our procedures and routines; undressing the patients, getting them into hospital clothing, performing the medical examination, establishing a diagnosis and then we ask the patients if they have any questions (ED nurse)

Information

Information to and from the patient

Informing the patient is important so that he understands the medical problem and agrees to the planned treatment (intern)

Competence

Variable competence

Interns are unexperienced and need supervision (ED nurse)

Barriers to patient participation

Older patients’ health status

Frail health status

The frail and thankful older patient

Small changes in the older patients’ health condition lead to severe consequences (ambulance worker)

The challenge with older patients is the compound medical picture (medical doctor)

A compound medical picture

Belonging to another generation

Older patients never complain and tolerate pain very well, they do not want to bother anyone (medical doctor)

Older patients are thankful

Barriers to patient participation

The time aspect

Time is limited

Hospital resources; available staff and beds

We have limited time for the patients, so when older patients want to explain what is wrong, we sometimes have to stop them (medical doctor)

High workload

One has to prioritize, if you spend much time on one of the older patients, then there is less time for other patients in the ED (intern)

Priority of time

How to conduct older patients’ participation

Respect

Involving the patient in practice

Healthcare professionals’ attitudes towards exploring older patients’ experiences

I like working together with the patient (medical doctor)

I think it is of high importance that we show we care (ambulance worker)

Show that we care

The patients say what they want if you sit down and ask them (medical doctor)

I think it is important that the patient feel he has a right to decide himself and [to feel] that we do not just overrule him by our procedures, which we easily can (medical ED nurse)

Older patients want to stay at home

Preference for participation

Patient involvement in ED not relevant

Older people want to stay at home as long as possible if they know help will come when needed (ED nurse)

Multiple transitions

I don’t think patient participation is very relevant in the ED (ED nurse)

It is important to not treat the older patient as a packet and transfer him from place to place (ambulance worker)

How to conduct older patients’ participation

Next of kin

The next of kin role

Presence of a supportive and demanding next of kin

Older people often call the next of kin instead of the doctor or the emergency services (ambulance worker)

Next of kin is first priority

It is not easy to get any information from the older patient in a bad health condition; then next of kin supports with useful and necessary information (intern)

Next of kin, an information source

Patients are more heard if the next of kin is present in the admission situation (ED nurse)

Patients heard if next of kin present

Next of kin can be challenging, having their own interests, which are not always the same as the patient’s (medical doctor)

Next of kin’s interests unlike the patient’s

For a nurse it is good to know that the patient is not alone in the room, he has his family present, especially when I am busy with other patients. Then I ask them to tell me when they are leaving (ED nurse)

Family, safety for patient and nurse