Research update: A global challenge – Empowering older people in hospital

16th December 2016

Patient empowerment through which patients can gain control over their health and healthcare is a common theme across health policies globally.  An international group of researchers led by the Cicely Saunders Institute has published research into patient empowerment among older people in hospital.

Researchers wanted to understand what barriers there might be to patient empowerment, and how patient empowerment could be facilitated.  So the research team interviewed patients, their informal caregivers, specialist palliative care staff and other clinicians caring for older people with advanced disease in six hospitals in England, Ireland and the USA.

They found that there were significant challenges to empowerment such as:

poor communication, and information provision

routinised and fragmented inpatient care

restricted patients’ self-management

restricted choice and decision making


But the researchers also found that specialist palliative care facilitated empowerment by prioritising patient-centred care, tailored communication and information provision, and prioritising the support of other clinicians.

They concluded that empowering older people in hospital requires changes throughout the health system including:

excellent staff-patient communication

patient-centred, relational care

organisational focus on patient experience

appropriate access to specialist palliative care


Their findings are particularly relevant for high- and middle-income countries with a growing population of older patients with advanced disease.

Publication details:

Selman LE,  Daveson  BA,  Smith M, Johnston B, Ryan K, Morrison RS, Pannell C, McQuillan , de Wolf-Linder S, Pantilat SZ, Klass L, Meier D, Normand C, Higginson IJ.  How empowering is hospital care for older people with advanced disease? Barriers and facilitators from a cross-national ethnography in England, Ireland and the USA. Age Ageing. 2016 Nov 3. DOI: 10.1093/ageing/afw193