"When illness dictates who I am": A hermeneutic approach to older adults with heart disease

Nurs Forum. 2018 Apr 26. doi: 10.1111/nuf.12258. Online ahead of print.

Abstract

Background and purpose: Heart failure (HF) is increasing in prevalence and will continue to do so with an aging population. Few studies describe, from a lifeworld perspective, the experiences of elderly people who are very ill and living with advanced HF, and how meaning about personal dignity in daily life is created.

Methods: Data were collected by in-depth interviews with 12 Portuguese older people with advanced HF. The transcribed texts from the interviews were analyzed using the phenomenological hermeneutical method.

Findings: The results demonstrate two main themes: the perspective of oneself as vulnerable and as a significant person.

Conclusion: Findings demonstrate the need for health care professionals to find an approach that ensures both quality medical care and, at the same time, acknowledges the uniqueness of each subject. From the elderly people's stories, it is clear that in order to retain a sense of dignity people need to be seen and respected for who they are. The information about life stories is often used to make possible biographical oriented care.

Keywords: Elderly; Heart failure; Hermeneutics; Lifeworld.