scholarly journals ‘You learn to live with all the things that are wrong with you’: gender and the experience of multiple chronic conditions in later life

2012 ◽  
Vol 33 (2) ◽  
pp. 342-360 ◽  
Author(s):  
LAURA HURD CLARKE ◽  
ERICA BENNETT
Keyword(s):  
Older Adults ◽  
Chronic Conditions ◽  
Later Life ◽  
Physical Symptoms ◽  
Multiple Chronic Conditions ◽  
Biographical Disruption ◽  
Masculine Norms ◽  
Loss Of Autonomy ◽  
And Gender ◽  
Depth Interviews

ABSTRACTThis article examines how older adults experience the physical and social realities of having multiple chronic conditions in later life. Drawing on data from in-depth interviews with 16 men and 19 women aged 73+ who had between three and 14 chronic conditions, we address the following research questions: (a) What is it like to have multiple chronic conditions in later life? (b) How do older men and women ‘learn to live’ with the physical and social realities of multiple morbidities? (c) How are older adults’ experiences of illness influenced by age and gender norms? Our participants experienced their physical symptoms and the concomitant limitations to their activities to be a source of personal disruption. However, they normalised their illnesses and made social comparisons in order to achieve a sense of biographical flow in distinctly gendered ways. Forthright in their frustration over their loss of autonomy and physicality but resigned and stoic, the men's stories reflected masculine norms of control, invulnerability, physical prowess, self-reliance and toughness. The women were dismayed by their bodies’ altered appearances and concerned about how their illnesses might affect their significant others, thereby responding to feminine norms of selflessness, sensitivity to others and nurturance. We discuss the findings in relation to the competing concepts of biographical disruption and biographical flow, as well as successful ageing discourses.

scholarly journals Living with multimorbidity? The lived experience of multiple chronic conditions in later life

2019 ◽  
Vol 24 (6) ◽  
pp. 701-718 ◽  
Author(s):  
Tom Porter ◽  
Bie Nio Ong ◽  
Tom Sanders
Keyword(s):  
Older People ◽  
Lived Experience ◽  
Chronic Conditions ◽  
Later Life ◽  
Constructivist Grounded Theory ◽  
Multiple Chronic Conditions ◽  
Long Term Conditions ◽  
Depth Interviews ◽  
Multiple Conditions

Multimorbidity is defined biomedically as the co-existence of two or more long-term conditions in an individual. Globally, the number of people living with multiple conditions is increasing, posing stark challenges both to the clinical management of patients and the organisation of health systems. Qualitative literature has begun to address how concurrency affects the self-management of chronic conditions, and the concept of illness prioritisation predominates. In this article, we adopt a phenomenological lens to show how older people with multiple conditions experience illness. This UK study was qualitative and longitudinal in design. Sampling was purposive and drew upon an existing cohort study. In total, 15 older people living with multiple conditions took part in 27 in-depth interviews. The practical stages of analysis were guided by Constructivist Grounded Theory. We argue that the concept of multimorbidity as biomedically imagined has limited relevance to lived experience, while concurrency may also be erroneous. In response, we outline a lived experience of multiple chronic conditions in later life, which highlights differences between clinical and lay assumptions and makes the latter visible.

Comorbidities of Physical and Psychiatric Syndromes in Later Life

2018 ◽  
Author(s):  
Lydia K. Manning ◽  
Lauren M. Bouchard ◽  
James L. Flanagan
Keyword(s):  
Older Adults ◽  
Chronic Conditions ◽  
Negative Impact ◽  
Later Life ◽  
The Body ◽  
Chronic Obstructive ◽  
Multiple Chronic Conditions ◽  
Obstructive Pulmonary Disease ◽  
Complex Interactions

There is a great deal of concern about the increasing number of older adults who suffer from chronic disease. These conditions result in persistent health consequences and have an ongoing and long-term negative impact on people and their quality of life. Furthermore, the probability that a person will experience the onset of multiple chronic conditions, known as comorbidities, increases with age. Despite the prevalence of comorbidity in later life, scant research exists regarding specific patterns of disease and the co-occurrence and complex interactions of the chronic conditions most closely associated with aging. It is important to review the body of literature on comorbidities associated with physical and psychiatric syndromes in later life to gain an overview of some of the most commonly seen disorders in older adults: hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, arthritis, depression, and dementia. Specific patterns of disease and the co-occurrence and complex interactions of chronic conditions in later life are explored. In conclusion, we consider the need for a more informed understanding of comorbidity, as well as a related plan for addressing it.

scholarly journals ‘The calendar is just about up’: older adults with multiple chronic conditions reflect on death and dying

2011 ◽  
Vol 32 (8) ◽  
pp. 1399-1417 ◽  
Author(s):  
LAURA HURD CLARKE ◽  
ALEXANDRA KOROTCHENKO ◽  
ANDREA BUNDON
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Chronic Conditions ◽  
Death And Dying ◽  
Multiple Chronic Conditions ◽  
Men And Women ◽  
Pain And Suffering ◽  
Prolonged Pain ◽  
Depth Interviews ◽  
Status Passage

ABSTRACTDrawing on data from in-depth interviews with 35 men and women aged 73–91, this article examines the ways in which older adults with multiple chronic conditions talk about and prepare for death and dying. While the focus of the original study did not include questions concerning the end-of-life, the majority of our participants made unprompted remarks regarding their own and others' mortality. The participants discussed the prevalence of death in their lives as it related to the passing of significant others, as well as their own eventual demise. Additionally, the men and women expressed hopes and fears about their impending death, in particular with respect to prolonged pain and suffering, institutionalisation, and a loss of mental acuity and independence. Many of our participants also described their end-of-life plans, which included making funeral arrangements, obtaining living wills, and planning their suicides. They further reported a number of barriers to their planning for death, including a lack of willingness on the part of family members to discuss their wishes as well as a scarcity of institutional resources and support. We discuss our findings in relation to the extant research concerning older adults' experiences of death and dying, as well as Glaser and Strauss' (1971) theory of status passage and Marshall's (1986) conceptualisation of authorship and the legitimation of death.

scholarly journals The Importance of Studying Health Behavior in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 827-827
Author(s):  
Jaime Hughes ◽  
Susan Hughes ◽  
Mina Raj ◽  
Janet Bettger
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Behavior Change ◽  
Chronic Conditions ◽  
Population Level ◽  
Multiple Chronic Conditions ◽  
Prior Work ◽  
Time Changes ◽  
The Impact ◽  
Over Time

Abstract Behavior change is an inherent aspect of routine geriatric care. However, most research and clinical programs emphasis how to initiate behavior change with less emphasis placed on skills and strategies to maintain behaviors over time, including after an intervention has concluded. This presentation will provide an introduction to the symposium, including a review of prior work and our rationale for studying the critical yet overlooked construct of maintenance in older adults. Several key considerations in our work include the impact of multiple chronic conditions, declines in cognitive and functional capacity over time, changes in environmental context and/or social support, and sustainability of community and population-level programs and services.

scholarly journals HEALTHCARE PROVIDERS’ EXPERIENCES IN CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S317-S318
Author(s):  
Jenny Ploeg ◽  
Marie-Lee Yous ◽  
Kimberly Fraser ◽  
Sinéad Dufour ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Home Care ◽  
Family Caregivers ◽  
Chronic Conditions ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Multiple Chronic Conditions ◽  
Team Approach ◽  
Personal Support

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.

scholarly journals Association between guideline recommended drugs and death in older adults with multiple chronic conditions: population based cohort study

BMJ ◽  
2015 ◽  
pp. h4984 ◽  
Author(s):  
Mary E Tinetti ◽  
Gail McAvay ◽  
Mark Trentalange ◽  
Andrew B Cohen ◽  
Heather G Allore
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Chronic Conditions ◽  
Population Based ◽  
Multiple Chronic Conditions
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