The care needs of community-dwelling seniors suffering from advanced chronic obstructive pulmonary disease.
OBJECTIVE
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.


RESULTS
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.
University of Alberta, Third Floor Clinical Sciences Building, Edmonton, Alberta T6G 2G3, Canada. donna.wilson@ualberta.ca
Donna M
DM
Wilson
Carolyn
C
Ross
Donna
D
Goodridge
Penny
P
Davis
Alison
A
Landreville
Kim
K
Roebuck
D000203:Activities of Daily Living; D000368:Aged; D000416:Alberta / Q000453:epidemiology; D000884:Anthropology, Cultural / Q000379:methods; D001294:Attitude to Health; D015577:Geriatric Assessment; D006699:Home Care Services; D006801:Humans; D015994:Incidence; D010166:Palliative Care / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing* / Q000503:physiopathology; D036301:Qualitative Research; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000379:methods