Table 1 Themes

Resource

Lowest effective level of care as a criterion for service allocation

“Home care services must be tried before you meet the criteria for short-term stays” (M3, I7).

Blanket allocation of low-cost care services

“Social alarms […] are a low-threshold service, so everyone who asks for it gets it” (M2, I5).

Severity

Severity of medical and rehabilitation needs

“According to the allocation criteria for long-term stay, there must be a somatic health failure and/or a dementia diagnosis that requires extensive medical treatment” (M2, DS).

“You were hospitalised due to a femoral neck fracture. After the hospital stay, you had a longer short-term stay at the nursing home for rehabilitation and medical treatment. You have gradually recovered physically, but still have varying health and motivation for exercise. The rehabilitation team will provide services for a period of training after you have returned home from the nursing home” (M3, GS).

Severity of care needs

“It is more difficult to motivate patients to receive services at home if the unease and anxiety is so great that we are not able to calm them” (M1, I1).

“As a result of reduced short-term memory and reduced cognitive function, there is a need for increased assistance from home nursing to ensure personal hygiene and that you eat” (M3, GS).

Benefit

Benefit of generous service allocation

“Many times, we want to secure the elderly who are discharged from hospital by allocating four home nursing visits a day, for example, at the start. Because it is a bit uncertain in the beginning. […] And then the home nursing staff may think that we have allocated far too much. And it may well be that they are right sometimes but wrong other times. And especially in transitions, I think we should be generous in the transition, and subsequently reduce [the level of services] instead” (M3, I7).

“We have services such as reablement which we really should invest even more in. […] Yes, for example, a reablement team that comes in and does exercises regularly for a certain period so that the older person may be able to go to the shops on their own” (M3, I8).

Benefit of avoiding services

“We have things that can be ordered so you can get your socks on. Stocking pullers and things like that. And it is important to focus on coping and what kind of resources they [the recipients] have” (M1, I2).

“Because if we go in with too much help, then… we shouldn’t deprive them of their autonomy over everyday life either. We are not going to take over functions they can handle themselves. So, it is very important to find out: ‘What can you do yourself?’ So that they can cope and experience that” (M1, I3).