Old people receiving municipal care, their experiences of what constitutes a good life in the last phase of life: A qualitative study

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Abstract

Background

Old people's life situation when receiving municipal help and care in their last period of life is sparsely investigated from their own perspective.

Objective

The aim of this study was to investigate the experiences of aspects that bring about a good life in the last phase of life among people (75+ years) receiving municipal care.

Participants

Older people living in a municipality in Southern Sweden being 75 years or older, receiving help and/or care from the municipality, and having a life-threatening disease and/or receiving palliative care were asked to participate. In all 17 people, 10 women and 7 men, aged 78–100 years were included.

Methods

Qualitative interviews, with the emphasis on their present life situation especially what brought about a good life, were performed. The interviews were analysed using qualitative content analysis.

Results

The experience was interpreted to be Turning inwards to come to peace with the past, the present and approaching death while being trapped by health complaints. Six categories embraced the experience of aspects that constitute a good life in the last phase of life: Maintaining dignity, Enjoying small things, Feelings of “being at home”, Being in the hands of others, trying to adjust, Still being important for other people and Completing life while facing death.

Conclusion

This study confirm theories suggesting that the last phase of life in old age meant focusing inwards, reflecting on the entire life as a way of completing it as well as enjoying small things and also viewing oneself in the perspective of contributing to the future. It also indicated that this phase of life meant being trapped by health complaints and functional limitations. The struggle to maintaining dignity as opposed to being in the hands of others implies that the concept of palliative care may be useful as a framework for providing nursing care to very old people, especially at the end of life.

Section snippets

What is already known about the topic?

  • Most people will die in advanced age and after a period of needing help and care from others.

  • Decreased functional ability is common in old age and is well known to affect QoL negatively.

  • Older people prioritise other areas in life than younger people do.

What this paper adds

  • Aspects that contribute to a good life in the last phase of life includes the possibility to maintaining dignity, enjoy small things, still being important for other people, to feel “being at home” and having the possibility to complete life while facing death. Being in the hands of others also contributes to a good life, but also means having to adjust.

  • An important component in the nursing care of old people at the end of life proved to be endorsing possibilities to reflect on the past and

Aim

The aim of the study was to investigate the experiences of aspects that bring about a good life in the last phase of life among people (75 years and older) receiving municipal help and care.

Method

The study was based on interviews with older people in their last phase of life. The criteria for inclusion were being 75 years or older, receiving help and/or care from the municipality, having a life-threatening disease and/or receiving palliative care, and being able to communicate verbally and participate in an interview. In Sweden, the municipalities are mainly responsible for nursing care, rehabilitation and service to older people, hereafter referred to as municipal care. This care and

Findings

The impression of text was that the life situation in the last phase of life could be understood in one overall theme, Turning inwards to come to peace with the past, the present and approaching death while being trapped by health complaints. The life situation was heavily coloured by health complaints such as pain, fatigue, and nausea, which limited life to an all-embracing extent and hindered maintaining the activities that had brought satisfaction in the previous everyday life. Health

Discussion

The aim of the study was to investigate the experiences of aspects that bring about a good life in the last phase of life. Interviews with 17 people receiving municipal care, being 75 years and older, were conducted. The results showed that the life situation in the last phase of life meant Turning inwards to come to peace with the past, the present and approaching death while being trapped by health complaints, and this could be understood in the categories Maintaining dignity, Enjoying the

Acknowledgements

We are sincerely grateful to the participants in this study who contributed their narratives during their last phase of life and also for the support concerning data collection from the nurses in the municipality. We are also most grateful to Department of Health Sciences, Faculty of Medicine, Lund University, and for financial support from Greta and Johan Koch's foundations and SSSH (Föreningen Södra Sveriges Sjuksköterskehem) and to Alan Crozier for revising the language.

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