Table 2 Overview of sub-themes supporting all main themes and secondary quotes grounding the subthemes

Recall and understanding of the intervention

A1 “The GP has a lot of elderly people in his practice, do they all get a letter? I: Yes, they do. P: So everyone ... so not that you say we will pick out a few ...? I: Yes {} But you tell me that you did not receive the invitation [to fill in the questionnaire] ... P: No, I did not get it. I: What kind of invitation did you receive? P: Well, just an invitation to come here [to the centre], that was the only invitation I got.” P9 F

A2: “Because I think you had to turn to the GP as well, didn’t you? The GP had then indicated which people were eligible for this. So in that respect the doctor played a part in it, didn’t she? So that’s, well, yes, people do have a lot of illnesses or whatever, right? In that way, it’s been brought into action you might say, hasn’t it? But otherwise she has nothing to do with it, I think. She probably won’t have time for that ...” P6 F

Satisfaction is not about the effect of the program

B1 “I have been treated nicely. Otherwise, I can’t say anything negatively about it. I wouldn’t advise against it to someone else either, but recommend it, oh well, I don’t know. Anyway, there’s nothing that I wasn’t happy with. That you say like, well, I would rather not have done it. {but} I don’t know what’s in it – there’s nothing in it. Not for me.” P21 M

Appreciation with the broad view of the program

C1 “My blood was also just checked again this week, because they doubted the thyroid gland, which was only slightly on the edge [the doctor] thought. Then, I went to be checked again, I’ll just wait for [that result] again. You can be very tired of that, too. But then again, we have been very tired for a very long time. And then [the nurse from Sage-atAge] said: “But that’s only logical, woman, you have so much going on in your head, that alone should get you tired”. I think: well, you are right. That was true enough.” P24 F

Other care workers are not meeting this need…

C2 “but I hope that they [care workers] can do something quickly. You always hope for that and yes, also in hospital. I don’t get anything there either. [there they say]: “You may come back in a year”, just like that. They just don’t give a moment’s thought to anything.” P4 M

…and they are not expected to meet this need

C3 “we only visit the GP when it’s very much needed, right? If you ... really have problems ... Or, yes, real problems ... If you’re really ill, say, then you’ll visit the doctor.” P6 F

Participants experience a lack of interest into this need with other care workers

C4 “Sometimes I also notice that with GPs: They just listen to your heart for a moment: “Oh yes, it’s still beating.” And then they listen to your lungs for a moment, “yes they are also still working. Well now, so you are not dead.” And for the rest, you may just figure it out. So no feeling with the human being behind the patient at all. [The GP can’t take care of everything] He doesn’t have to, but he should have an antenna for picking up someone’s signals.” P11 M

Need for support

C5 “I don’t have the opportunity to always read everything I’d like to [because of vision problems]. {} I don’t play a part in anything anymore, do I? I listen to the radio to hear the news all day long, and if something is wrong, well ... But, there are also things you should just actually read, shouldn’t you? So that it really sinks in. {} [with the nurse at Sage-atAge] I could at least just tell my story and I thought that in itself this was a start to set everything in motion, wasn’t it?” P2 M

C6 “Especially checking the medication is important to me as well. And nothing had to be changed about it, but that people paid attention to it. You can never know.” P2 M

Unable to recall the agenda of the CGA

D1 “I: And do you still remember what [the CGA] was about then? P: Yes, it was also all about those ordinary things. Yes, I just call it ordinary things. It was all about how you lived and what you could still do and this and that and about all of those things. But exactly, the specific details, that I don’t know anymore.” P20 F

D2 “I: Yes ... And when the doctor came here to visit ... Do you still remember how that was then? {} P: Yes, I do. Talking a bit about everything, right? S: Yes, of course you start with an open mind, don’t you? I: And that conversation ... How did that go? P: Well, it went alright. Yes, I think I could give an answer to whatever she asked.” P5 M

Uncertainty about the goal of the program

D3: “I: And before the doctor came here - did you have any idea of what she would come and do here? P: No, not at all, right? No, because we thought it was something that our doctor would help with or so. Yes, that’s what I was thinking. And am I right? That she will then have a better overview of our family or something?” P3 F

Questionnaire guided the agenda of the CGA

D4 “I: Had you then thought in advance about what you were going to discuss during that conversation? P: No, I hadn’t, because that had already been noted in my questionnaire, right? [The conversation] was more an explanation of what I had already said in the questionnaire. Well, she asked some additional questions about and around that and so on. So, well, I felt that it was going quite alright.” P11 M

D5 “S: At some point [the nurse] then says: “It’s about time that I should deal with my questions, because otherwise it will take much too long.” I: because what actually were her questions then? P: Well those were, they actually were related to the list that I had filled in. And so I did answer those.” P15M

Scientific design of the program

D6 “Ok, well, that conversation was not useless. But yes, I actually did, I thought, answer all sorts of questions in the questionnaires, so I believe that conversation didn’t have any added value. That was not this lady’s [Sage-atAge nurse] fault, but let’s put it this way, I’m not any the wiser. Well, it was a research, so then you are not supposed to be any the wiser, but you are expected to make the researcher wiser.” P12 M

Unexpected problems discussed

E1 “I’ve also received a card from her, because it was also about some personal things with her in the end, and that was very nice, too, and well, then she had something like, then give – I’ll give you my card, right, if ever you think you’ll need me again, you may always call me.” P24 F

Unexpected solutions

E2 “I did speak with someone from social support. They now know what the situation is like here, so in general I benefited from it to some extent. If anything happens to me, they know about my wife’s situation [for whom he is care giver]..” P21 M

Passive role

F1 “They really want you to. That’s why I say: I’ll just take part in it. {} For my doctor and for myself as well, of course.” P9 F

F2 “There’s no harm in it anyway. I thought: They are launching a new project there, I’ll just contribute to that. But not with a certain expectation or so.” P6 F

Initiation

F3 “Yes, she would discuss it with the GP ... And then you don’t hear anything. Then you have to ask about it yourself. {} You would like to contribute alright, but I think the other side should come up with something as well.” P5 M

Agenda

F4 “you’re waiting for what that lady would say.” P1 M

F5 “I: But do you still remember what you talked to her about? P: Yes, also about, these things rather. Yes, yes, but everything specifically, she asked and then I just answered in fact. That’s how you should see it.” P4 M

Actions expected by the care workers

F6 “I: So the care worker came to visit you at home. P: Yes, he did, because I could have come myself [to the research centre]. But that was not necessary.” R23 M

F7 “So I knew that [the nurse] would contact the GP. But I didn’t know what would happen next, so then I already thought, yes, should I be the one to take initiative, will I have to call her later or how does that work. Oh well, I thought, just wait and see for a while. But then that [family doctor] visited, personally. {} The GP had actually signed me up to that project, so it’s only logical that people from that project will give feedback to the GP about the results.” P11 M

No actions carried out by participant

F8 “That’s how I found out that the cause was the diuretics that were affecting me badly. So then I said to that pharmacist like, what do you say about this? Shall I just leave them? Because I still have some problems with dizziness… Never heard of anymore.” P8 M

F9: [reading out the goal card]: “‘Increasing the activities around movement a bit and possibly go to [the community centre]’. You have to do that apparently because we haven’t heard anything from that either. Actually we haven’t heard about anything at all.” P7 F

Unsolved misconceptions

F10 “Yes, we would like to contribute, but we didn’t really know what it means. And I actually still don’t know, but I thought it was about help, for the doctor. For our family doctor, and that she would ... would then explore our household a bit and what was there.” P3 F

F11 “I never really understood that it was for me. I had the idea that it was part of the research.” P12 M

Ageing is about uncertainty

G1 “I: [how can we make sure we reach those who will benefit from this]? P: Well, of course at this age that may change per month, eh? So yes, that’s difficult.” P7 M

Changes occurred within timeframe of program

G2 “then .. the first time someone came here, nothing was wrong with me, but then there was during the second time.” P3 M

G3 “I have very bad eyesight, and then [the Sage-atAge nurse] also talked about Visio [a vision-aid centre]. And then I said to her like, “Well, I won’t need that yet. I’ll be fine like this.” But now I do need them. {} It used to be fine, until four, five weeks ago. I suddenly got a dark spot in front of the eye {} Yes, I needed it faster than I expected myself.” P14 F

G4 “And I also have a sore knee and I didn’t mention that {} at that moment it wasn’t hurting so much and then I forgot about it.” P10 F

Synchronization with other health care

G6 “I: Has that also been discussed then [at the CGA]? P: No, it hasn’t ... That, eh, I haven’t mentioned that anymore. Because we were already working on that [with the GP].” P2 M

G7 “I: Have you also discussed the memory with [the Sage-atAge nurse]? P: No, I haven’t. {} Then we didn’t know it yet. Then we hadn’t visited that doctor in hospital ...” P16 M

Counselor would solve timing difficulty

G8 “{Sage-atAge} is a start I think, yes. Well, this is only just an inventory. {} I: and would you like it if that nurse would see you again? P: Well, it doesn’t necessarily have to be a nurse, because there is nothing to nurse here. So it doesn’t really matter who that is as long as he’s part of such a project or organization. {} I: and that he will come back once in a while? P: Yes, otherwise it doesn’t make sense. A one-off doesn’t make sense. So that should actually become standard procedure.” P11 M

G9 “All those people [he met at a ward when he was hospitalized] could use a director. I think that would be a good addition to supporting ill people, including simple material matters. {} There are so many annoying things in life, which will be going to be 100 %, one thousand percent more difficult if you fall ill. {} that if they have a question about something, that they know they may call someone in confidence.” P12 M

Questionnaire is lacking the narrative

H1 “[the Sage-atAge nurse] said: “You sometimes feel lonely, too.” I said “No, not that I know of.”. She said “You did fill that in.” I said “Well, then that was a mistake.” So therefore she has been here again and we talked about it once more. {} But yes, I’m on my own, but I don’t feel lonely.” P14 F

H2 “Alright, so there may have been a few leads for [the Sage-atAge nurse] to come here, because I might have answered a bit differently from the average answer, that’s possible. I was probably a doubtful case.” P15 M

Expecting physical scope

H3 [reads out problem on the goal card]:“‘preferably be a bit more mobile’. Yes, I do fortunately have my car, but otherwise I would be completely stuck at home! [reads out] ‘Preferably be a bit more among people’ ..., oh well, I am. {} No, I can’t do all that much with this [goal card]. [I only have a problem] with diabetes, which isn’t mentioned on it. I: and the things that are on it, are these matters for you that were relevant at that point? P: Yes, that’s private, if I want to play cards then I’ll just do so. Which, it seems to me, doesn’t have anything to do with that. S: That is a leisure activity.” P8 F

H4 “Well, we went through everything a bit. I am quite reasonably aware of how I’m put together. It isn’t an examination, not a medical examination. So like ingrown toenails and so on, they are not mentioned.” P12 M

No urgency for prevention

H5 “But anyway, yes, you should try to live a bit healthily, but not at all costs. Because then I think the quality of life is losing out. Then you do have a healthy body that may want to get old, but a certain quality of life is part of it as well, and I think that is missing then. If I can’t smoke my cigarette, can’t have my drink, yes, then nothing will be left anymore.” P11 M

H6 “I have to exercise more but that is considerably inhibited by my heart condition {}. I can’t do more than that. Things should remain pleasant, right? I think it’s important to get “healthily old” but that’s not an end in itself. You have to be able to grow old in a pleasant way. There’s no point at all in filling your days with horizontal bar exercises in order to win another year.” P12 M

Coping/Secondary control/Acceptance

H7 “We aren’t getting old in a healthy way. When we get older, everything starts to crack, I sometimes say. But yes, you hear that from a lot of people {} Yes, they all suffer from it in some way.” P14 F

H8 “And I also try to walk in succession as far and as long as possible. Because sometimes I don’t have any energy left. Then I walk a short distance and then I have to sit on my walker. And then walk a bit further. And then when I have walked all the way out and back, then I praise myself. I think that’s so beautiful then. I did manage to walk all that. That used to be quite normal, but now everything isn’t normal.” P20 F

Unfounded hope

H9 “I: [What did you expect from Sage-atAge?] R: Well, I … that it could be useful to me when they could help me with this [with the oxygen therapy] {} But anyhow, I don’t get any support, I don’t have to count on that, no.” P4 M