Palliative and supportive needs of older adults with heart failure

Authors

  • J. D. Cortis phd, msc, bsc (hons), dip. nurs. (london) rgn, rmn, rnt,

    Corresponding author
    1. Senior Lecturer, School of Healthcare, University of Leeds, Leeds, UK,
      Dr Joseph D. Cortis, School of Healthcare, University of Leeds, c/o Baines Wing, PO Box 214, Leeds LS2 9UT, UK; Tel: 0113 3431206; Fax: 0113 3431204; E-mail: j.d.cortis@leeds.ac.uk.
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  • A. Williams rgn , msc, bsc (hons)

    1. British Heart Foundation Heart Failure Nurse Specialist, North Bradford Primary Care Trust, Bradford, UK
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Dr Joseph D. Cortis, School of Healthcare, University of Leeds, c/o Baines Wing, PO Box 214, Leeds LS2 9UT, UK; Tel: 0113 3431206; Fax: 0113 3431204; E-mail: j.d.cortis@leeds.ac.uk.

Abstract

Background:  Chronic heart failure (CHF) affects older people and carries a heavy burden in terms of poor prognosis and quality of life. Palliative and supportive care services are being advocated in the UK to relieve that burden but older people’s needs require further understanding to ensure effective service models.

Aim:  To explore the experiences of older adults with CHF to gain a deeper understanding of their palliative and supportive needs and the value of possible interventions.

Methods:  This qualitative study collected data from ten patients with CHF in New York Heart Association Classes II to IV, aged 80–90 years, attending a support programme. Semi-structured interviews were conducted and transcripts were analysed using constant comparative analysis.

Findings:  The narratives revealed the consequences of living with heart failure in terms of physical symptoms and disability, psychological sequalae, social isolation and existential concerns. The variety of ways in which participants adjusted to and coped with these consequences was revealed in terms of their approach to their illness, and utilizing the resources available to them, including the support programme. Needs were conceptualized in terms of requirements to supplement deficits in coping resources.

Conclusions:  Services designed to meet palliative and supportive needs of older people should aim to identify individual coping strategies and resources and highlight deficits in order to target appropriate interventions.

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