The growing older adult population, their age-related morbidities, and lifelimiting
chronic illnesses increase the demand for quality yet cost-effective end of life
(EOL) care. Losing a loved one creates emotional turmoil, heightened uneasiness, and
EOL uncertainties for family members. Understanding the complex needs of family
members and supportive actions deemed most significant to them can guide nurses to
enhance EOL care, encouraging palliation and peaceful death experiences. This study
used a qualitative descriptive exploratory design guided by story theory methodology to
explore the dimensions of the health challenge of losing a loved one who had been in an
acute care setting during the last three months of life, the approaches used to resolve this
health challenge, and turning points that prompted decisions about a loved one’s care
with 15 older adults residing in a Continuing Care Retirement Community (CCRC) in
Southeast Florida. Theoretical grounding for this study was Watson’s (1988, 2002)
theory of human caring and Smith and Liehr’s (2014) story theory. Older adults’ stories
were analyzed through theory-guided content analysis. Themes that describe the health challenge include moving from painful holding on to poignant letting go, uneasiness that
permeates everyday living and precious memories, patterns of disconnect that breed
discontent, and pervasive ambiguity that permeates perspectives about remaining time.
Approaches to resolve this challenge include active engagement enabling exceptional
care for loved ones, appreciating the rhythmic flow of everyday connecting and
separating to get by, and embracing reality as situated in one’s lifelong journey. Failure to
establish normalcy, coming to grips with abrupt health decline/demise, and recognition –
there’s nothing more to do – were the turning points identified by CCRC residents. Older
adults’ vivid recollections of losing a loved one and willingness to share EOL concerns as
well as recommendations regarding support of family members who are facing this
challenge serve as invaluable guidance for improving EOL care for dying patients and
their family members. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection
| Identifer | oai:union.ndltd.org:fau.edu/oai:fau.digital.flvc.org:fau_33494 |
| Contributors | Sopcheck, Janet (author), Liehr, Patricia (Thesis advisor), Florida Atlantic University (Degree grantor), Christine E. Lynn College of Nursing |
| Publisher | Florida Atlantic University |
| Source Sets | Florida Atlantic University |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation, Text |
| Format | 222 p., application/pdf |
| Rights | Copyright © is held by the author, with permission granted to Florida Atlantic University to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder., http://rightsstatements.org/vocab/InC/1.0/ |
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