Palliative and supportive needs of older adults with heart failure.
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.


OBJECTIVE
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.


RESULTS
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.
Cortis
J D
JD
School of Healthcare, University of Leeds, Leeds, UK. j.d.cortis@leeds.ac.uk
Williams
A
A
D000223:Adaptation, Psychological; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000451:nursing* / Q000523:psychology; D006801:Humans; D008297:Male; D033262:Narration; D020380:Needs Assessment; D010166:Palliative Care; D011788:Quality of Life; D012944:Social Support; D006113:United Kingdom