According to Hopson et al. (1992) there are seven stages of transition, although individuals may not experience every stage. The sequence begins with numbness which may involve the person being shocked, in disbelief or unable to act. Initially, the person’s self-esteem will be at a medium level. The next stage is denial which suggests the person is refusing to accept what is happening and their self-esteem has increased slightly above the middle level. Following on from denial is the depression stage. At this stage, the person may be intimidated by the implications of change, and their self-esteem has decreased again. However, it will still higher than at the initial stage. After depression comes acceptance, it is here that the person is starting to accept their new situation and leave behind the old one. Here their self-esteem is at its lowest. After the acceptance comes the testing stage. This particular stage is when the person evaluating their new situation and what is acceptable there. At this stage, the person’s self-esteem is beginning to increase again but is still slightly lower than stage three. Following on from the testing stage is the search for meaning stage. This is when the person begins to contemplate their new life and what the transition means. At this stage their self-esteem is much higher than the initial level. Lastly, the person fully accepts and understands their new situation, this is known as internalisation. It is at this final stage that the person’s self-esteem has reached its peak. Healthcare staff can help make transitions in care a positive experience by recognising the seven stages and changes in self-esteem and providing support through the transition.
Making Transion Easier
Transitions may be easier for everyone if carers and care workers involve those undergoing the transition in the decision making. For example, if a person had made the decision themselves, instead of their family, to leave their home and move into a care home, they may have settled easier initially and may not feel more positive about the move (Open University, 2014)
If healthcare staff can help service users plan and prepare for a transition, listen and provide service users with support when making decisions this can help make transitions in care a more positive experience (Open University, 2014).
According to Peace (2015) ‘home’ means more than physical surroundings. If carers and care workers understood the social and psychological attachment to ‘home’ in addition to the physical attachment, this could help carers understand the feeling of loss that happens when people leave their home (The Open University, 2014) and help make transitions in care more positive.
Healthcare staff can also help make transitions in care more positive by understanding people’s routines and providing continuity and by managing transitions (Petch, 2009). It is important to have time to allow for continuous support to facilitate adjustment and that people should be fully informed to allow them to review different options (Open University, 2014) Support should be provided to allow decision making to be controlled by the person and ensure the person’s choices and preferences are recognised. Finally, recognition of diversity and cultural needs alongside recognising the individual’s life history.
The Open University (2014) ‘Activity 10.5: A Day in Alice’s Life’, K101 Learning Guide 10: Transitions in Care [Online]. Available at: https://learn2.open.ac.uk/mod/oucontent/view.php?id=635048§ion=3.1 (Accessed: 14 May 2017)
The Open University (2014) ’Learning Guide 10: Transitions in Care, K101 Block 3: ‘The Context of Care’ Milton Keynes, The Open UniversityTransitions in Care
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