'It is a completely new world you step into.' How older clients and their representatives experience the operational access to Dutch long-term institutional care

Purpose of the study: The access process is an important first step in the long-term institutional care for older people. Access can be seen as a concept consisting of three closely related dimensions: availability, affordability and acceptability (three A's). This study takes a new perspective by investigating how older clients experience the access process.

Design and methods: Data were gathered through interviews with representatives of clients that were recently admitted in a long-term care facility, or if possible with clients themselves. A total of 33 respondents from 4 organizations that provide long-term institutional care were interviewed.

Results: The first contact with the long-term care provider was made in several different ways. Finding a location nearby family was a common aim, which in urgent situations was not always feasible. Most respondents were satisfied about the process and felt taken care of personally. Yet, many respondents mention the lack of practical information and 'guidance' in the complexity of elder care. For acceptability, having a dedicated liaison in the organization was relevant.

Implications: The study revealed that the 3A model can be used to understand how older clients or their representatives experience the operational access process to long-term care. Especially the dimensions' availability and acceptability seemed to shape their experience. (C) 2015 Elsevier Inc. All rights reserved.