From Silence to Signal: How Older Adults Narrate Clinical Urgency

Introduction. The growing distinction between “urgent care” and “emergency care” has led to the development of intermediate healthcare structures, such as Urgent Care Centers. However, in Italy, a persistent confusion between the two concepts continues to limit awareness of out-of-hospital care options.

Goals and Methods. The study aims to systematize the elements that define clinical urgency from the perspective of older adults. Data will be collected through individual and dialogic storytelling sessions involving older adults with diverse profiles: non-self-sufficient individuals and their caregivers, those living with chronic conditions, and those recently discharged from hospital care. Participants will be recruited through community health services and geriatric outpatient clinics sited in Bologna. Interpretation will follow a data-driven approach and narrative thematic analysis.

Results. Framing urgency within elderly population cohorts introduces complexity and originality for several reasons: (i) perceptions of urgency are shaped by the intrinsic and multidimensional frailty of older individuals; (ii) clinical issues are often identified and communicated  by caregivers; (iii) assessment of seriousness informs the selection of appropriate care settings. The expected results will seek to capture the inherent nuances of urgency and anticipated benefits are twofold: at the individual level, by enhancing the agency of older adults within co-design processes of healthcare services and, at the community level, by offering evidence-based guidance to policymakers and stakeholders for the development of responsive and inclusive care models.

Conclusions. The qualitative methodology of storytelling, traditionally used to report lived experiences of chronic disease and end-of-life, can be adapted to the narration of an urgent situation clearly delineating the phases of recognition, communication, and coping. Narrative thematic analysis will identify recurring patterns while preserving implicit meanings (metaphors, tone, omissions) essential to the sense-making process.