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The Care Needs of Community-Dwelling Seniors Suffering from Advanced Chronic Obstructive Pulmonary Disease

Published online by Cambridge University Press:  31 March 2010

Donna M. Wilson ,
Carolyn Ross ,
Donna Goodridge ,
Penny Davis ,
Alison Landreville  and
Kim Roebuck
Donna M. Wilson*
Affiliation:
University of Alberta
Carolyn Ross
Affiliation:
University of Alberta
Donna Goodridge
Affiliation:
University of Saskatchewan
Penny Davis
Affiliation:
University of Alberta
Alison Landreville
Affiliation:
University of Alberta
Kim Roebuck
Affiliation:
University of Alberta
*
Requests for offprints should be sent to:/Les demandes de tirés-à-part doivent être adressées à: Donna M. Wilson, R.N., Ph.D., Caritas Nurse Scientist and Professor, Faculty of Nursing, Third Floor Clinical Sciences Building, University of Alberta, Edmonton, Alberta T6G 2G3, donna.wilson@ualberta.ca
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Abstract

Aim: This study was undertaken to determine the care needs of Canadian seniors living at home with advanced chronic obstructive pulmonary disease (COPD).

Background: COPD is a leading cause of morbidity and mortality worldwide. Although hospitalizations for illness exacerbations and end-stage care may be common, most persons with COPD live out their lives in the community. Little is known about the care needs of this significant population.

Methods: This study was guided by the research question: “What are the care needs and care priorities of senior citizens with end-stage COPD?” An ethnographic qualitative approach was used to address this question. Twelve community-dwelling seniors living in a Canadian city and diagnosed with advanced COPD were interviewed three times in their homes over an eight-month period in 2006.

Findings: Three themes emerged, each with concrete care needs: (a) self-reliance and independence through adaptation, (b) stable health through maintenance, and (c) living with constraints. The predominant theme was that all participants wanted to maintain their independence. This required considerable adaptation, as well as assistance from others.

Conclusions: Ensuring and improving assistance is important to prevent additional suffering and reduce exacerbations requiring hospitalization, a particularly important aim given the high and rising incidence of advanced COPD. A number of other insightful findings reveal the significance of learning directly from the persons who live with chronic illnesses about their lives.

Résumé

But: La présente étude visait à déterminer les besoins en matière de soins de santé des aînés du Canada vivant à domicile et souffrant de maladie pulmonaire obstructive chronique (MPOC) avancée.

Données générales: La MPOC est l'une des principales causes de morbidité et de mortalité dans le monde. Bien qu'il soit courant qu'une personne soit hospitalisée lors de l'exacerbation d'un processus morbide et qu'elle ait besoin de soins en phase terminale, la plupart des personnes souffrant de MPOC passent toute leur vie dan la communauté. On sait peu de choses sur les besoins en soins de santé de cette importante population.

Méthodes: La présente étude reposait sur le protocole de recherche: «Quels sont, en matière de soins de santé et de priorités, les besoins et les priorités des aînés souffrant de MPOC en phase terminale?» Nous avons utilisé une méthode ethnographique qualitative pour traiter cette question. Douze aînés vivant dans la communauté dans une ville canadienne et ayant reçu un diagnostic de MPOC avancée ont été interviewés trois fois chez eux au cours d'une période de huit mois en 2006.

Résultats: Trois thèmes ont été dégagés, chacun assorti de besoins concrets en soins de santé: a)autonomie et indépendance par l'adaptation, b) santé stable grâce à des soins intégrés, et c) vivre avec des contraintes. Le thème prédominant était que tous les participants souhaitaient conserver leur indépendance. Cette situation exigeait une adaptation considérable, ainsi que l'aide des autres.

Conclusions: Il est important d'assurer et d'améliorer l'aide si l'on veut éviter des souffrances supplémentaires et réduire les exacerbations exigeant l'hospitalisation, un but particulièrement important étant donné l'incidence élevée et croissante de MPOC avancée. D'autres résultats éclairants révèlent l'importance de l'apprentissage direct de personnes qui vivent presque toute leur vie affligées d'une maladie chronique.

Keywords

vieillissementsoins de santébesoinsethnographiecommunautépalliatifmaladie pulmonaire obstructive chroniqueaginghealth careneedsethnographycommunitypalliativechronic obstructive pulmonary disease
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 27 , Issue 4 , Winter/Hiver 2008 , pp. 347 - 357
Copyright
Copyright © Canadian Association on Gerontology 2008

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