Background: Multimorbidity in the elderly is associated with increased need of emergency care and the use of ambulance care increases with age. To maintain a sustainable care of high quality while at the same time effectively meeting the demographic change with an aging population, a major restructuring of Swedish healthcare is underway. However, there is limited knowledge about prehospital care of older people with complex care needs and the role of the ambulance service in the concept of a care closer to the patient. 

Aim: To describe ambulance clinicians’ experiences of caring for older people with complex care needs.

Method: A qualitative interview study with a strategic sample consisting of 18 ambulance clinicians in two different Swedish regions. The material was analyzed with thematic content analysis.

Results:Caring for older people with complex care needs is a common undertaking for the ambulance service that at the same time involves numerous challenges. The analysis of the experiences from ambulance clinicians revealed four themes: Relating to a common but multifaceted patient, Transferring knowledge and information at all levels, Striving for optimal level of care for the patient as a person and Lacking clarity about the role and mission. Ambulance care has an important role in the transition to a care closer to the patient, however, the assignment needs to be defined and the responsibility in relation to other actors clarified. 

Conclusion: A well-developed collaboration between ambulance care, inpatient care, primary care, and home care through a person-centered approach could promote that the right person be offered the right care, in the right place, at the right time.

Implication for caring in a changing world: To provide equal and efficient ambulance care adapted to a changing world, a collaborative approach is required, bridging organizational boundaries to focus on the patient as a person.