Spouses who placed partners in care homes experienced emotional reactions to separation and made efforts to maintain their relationship.

QUESTION: What are the experiences of family carers after placing a spouse in a care home? Design Grounded theory. A municipality in southern Sweden. Participants 12 spouses {8 wives and 4 husbands}* who had placed a partner in a care home within the past 6–12 months. Methods In semistructured interviews, participants were asked about their experiences after admitting a spouse to a care home. Interviews were audiotaped and transcribed. Constant comparison was used to elaborate on the themes derived from a previous set of interviews, particularly the processes of separation and continuity in maintaining relationships (" keeping "). The process of separation included 4 elements: pretending , dawning, putting on a brave face, and seeking solace. Pretending involved the carers convincing themselves that their spouse's admission to a care home was simply a trial separation and was not permanent. Dawning referred to the growing awareness that the placement was permanent. Subverting their feelings and needs led the carers to putting on a brave face, which could continue long after the admission of their partner to the care home. Some carers would seek solace and attempt to discuss their feelings with relatives, friends, and professionals. In most cases, however, the focus of attention was on the spouse entering the care home, and the car-er's needs were not addressed. The core theme of keeping explained carers' efforts to maintain their relationship with their spouse. Initially, an urgency existed to keep it going and spouses attempted to sustain near normal relationships. The carers had practical tasks that gave them a sense of active involvement with their spouses. Carers also described efforts to keep in touch and keep it special. They tried to keep their spouses in touch with previous pastimes, hobbies, and social contacts. Keeping it special involved attention to the spouse's personal preferences and rituals that had developed between the carer and spouse. Carers also engaged in keeping an eye on the care that staff provided to their spouse. Interactions with care staff ranged from keeping your distance (minimal contact with staff), keeping quiet (engaging staff on a polite but superficial level), keeping on trying (carers role modelled care they wanted staff to provide), to keeping it close (carers and staff working in partnership). Conclusions The process of separation experienced by family carers after placing a spouse in a care home included 4 elements: pretending, dawning, putting on a brave face, and …