A descriptive study of losses associated with permanent long-term care placement.

Objectives: This qualitative study describes the process of and factors associated with losses connected to permanent long-term care (LTC) placement of the elderly.

Methods: Five subjects were recruited on a voluntary basis upon consultation with a staff member of a small rural long-term care facility in Northeast Arkansas. Researchers conducted 1 to 2, hour to hour-and-a-half interview sessions with each participant. In order for subjects to be included in the study, participants met the following criteria: placement within the past 12 months, absence of acute disease, and cognitive ability to respond to and communicate during interview sessions. The interviews were taped with the patients' consent, and then transcribed word for word. The transcriptions were analyzed for emergent themes using the grounded theory approach.

Results: Qualitative analysis revealed several themes related to losses associated with LTC placement. These include: cohort losses, defined as losses that participants identified with as a cohort through lived experiences; antecedent losses, defined as losses that have contributed greatly to long-term care placement; and consequent losses, defined as losses that have been experienced as a consequence of placement.

Conclusion: The cumulative nature of losses that eventually results in LTC placement is an important consideration in geriatric physical therapy practice. The study highlights the physical therapist's role in prolonging function, preserving quality of life, and preventing for as long as possible LTC placement. Losses identified as leading to LTC were found to be in alignment with current research. Transitioning to LTC may interfere with the need to attend to end-of-life role expectations, resulting in the experience of additional loss. Gender-related differences appear to be significant as well, with males expressing a marked sense of loss of meaningful activity.