Background: The growing number of older adults worldwide coupled with chronic disease challenges already strained healthcare systems. Healthcare and social care is obliged to coordinate care and support upon discharge. In addition, individuals have a legal right and willingness to participate in the planning for support. Despite efforts to make healthcare person-centered and improve the interaction between different healthcare providers in clinical practice, previous research indicates that healthcare systems remain fragmented, having poor coordination when delivering care.

Aim: To describe older adults' experiences of being discharged from in-patient care to home.

Methods: This study had a qualitative descriptive design, enabling straight descriptions of older adults' experiences of being discharged from in-patient care to home. Individual semi-structured interviews were conducted with 17 older adults (aged 65 years, or older) living in the south of Sweden, with chronic diseases and in need of coordinated care transitions. Data were analyzed using inductive qualitative content analysis.

Results: The analysis yielded four generic categories and the main category “Being the main character but not always involved in one's own care transition”. This indicates that older adults are not always involved in the planning and decision-making regarding their care transition leading to a mismatch between actual needs and the expectations of planned support after discharge.

Conclusions: The study reveals a notable disparity between the assumed central role of older adults in care transitions and their insight and involvement in planning and decision-making. The findings are significant in the context of person-centered care, which emphasizes the importance of tailoring healthcare services to the individual's unique needs and preferences.