Coming to terms with the need for home care: a reflexive thematic analysis of older adults’ experiences in Sweden

BACKGROUND: Although publicly funded home care in Sweden is available to all based on municipal needs assessments, many individuals ≥65 years do not apply until their needs have become extensive. The aim of this study was to explore how older people experience the phase of life leading up to their decision to apply for home care for the first time. METHODS: Individual, semi-structured interviews with 14 men and women aged 67-94 years with first-time home care in 2024 in Stockholm, Sweden, were analysed with an experiential and inductive approach to reflexive thematic analysis. Transition theory in nursing was applied as a sensitising framework. RESULTS: We created 35 codes and the theme 'Coming to terms with the need for home care ‒ a movement that ebbs and flows', describing the fluctuating process of accepting increasing needs for support through home care. While some navigated this process pragmatically, for others it involved identity redefinition. Significant others sometimes became a driving force in the individual's process of acceptance. CONCLUSION: These findings expand the understanding of why individuals may hesitate and delay entering home care despite having support needs and suggest that some may initiate home care use while remaining ambivalent about this decision.