The role of community health nurses in providing information and referral to the elderly: A study based on social network theory

Community service such as healthcare, income assistance, transportation and recreation programs can help the elderly recover from illness and continue living in their own homes. Previous research has shown, however, that the elderly are largely unaware of existing services. Community health nurses, who regularly see seniors at community clinics, are in a key position to link seniors with local services through information and referral (I&R).;The purpose of this research was to investigate the nurse's role as an information provider in the senior's social network. The theoretical framework was derived from Granovetter's (1973, 1982) theory of the strength of weak ties, which suggests any individual's network comprises weak ties (acquaintances) and strong ties (close family, friends), but that weak ties are more useful sources of new information because strong ties usually possess the same information as the individual. It was expected that this study would identify the nurse as a weak tie who provides human services information (HSI) not available through strong ties, but that the senior would not use this information without first conferring with family.;In this qualitative study, observation of 24 nurses working with 108 seniors at 30 foot clinics yielded 24 dyads for detailed study. Each incident of nurse information-giving was followed by independent, in-depth interviews with the nurse and with the senior, and again with the senior two months later, to elicit accounts of the information-giving process. The study revealed that nurses were indeed weak ties who played a crucial role in linking seniors with local services. However, they provided this information in a caring manner characteristic of strong ties. Evidence also revealed that HSI helped seniors in diverse ways, but that seniors followed through on only 20% of referrals and tended not to consult strong ties first. Nurses devised various strategies for disseminating HSI according to their assessment of the senior's needs. The clinic setting emerged as an "information ground" for the informal sharing of information about human services. This research elaborates on Granovetter's theory and provides insights into the information behaviour of seniors and health professionals. Implications for information service providers are discussed.