Dignity and significance in urgent care: older people's experiences

In this paper we report the role that a sense of significance plays in the experiences of older patients in urgent care settings, and explore the factors that influence these experiences. The paper draws on findings from a UK study in which 69 patients and 27 relatives from 31 English NHS Trusts were interviewed about their urgent care experiences using semi-structured qualitative interviews. Key among the findings was that older patients experienced a diminished sense of their individual significance. Some questioned the legitimacy of their presence in the urgent care setting and believed that they mattered little in relation to other patients and the other tasks which health professionals were undertaking. The three key features of this diminished sense of significance were: the primacy of technical, medical care; an imbalance of power; and the subordination of patients’ non-medical needs. These features suggest that interventions to enhance care delivery that promotes a sense of significance will need to target practitioners and the wider organisational cultur