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UBC Theses and Dissertations

When the ability to live independently is threatened : a phenomenological study of the older adult’s experience of living "at risk" Hunt, Phyllis Marie


By the year 2031, the proportion of the population aged 65 and over will comprise approximately 23.8% of Canada’s population (Government of Canada, 1991). Currently, this group of older individuals uses a large amount of medical and social services because of its multiple medical and social problems, functional impairments and emotional disorders (Alexander, 1 990). One result of the availability and use of these services is that many older adults are now living at home in the community in situations of “risk.” The existence of multiple problems or risk factors threatens the older adult’s ability to continue living independently in that they represent the potential for a decline in health status and functional abilities which, in turn, may result in admission to an acute or long-term care facility. A review of the literature reveals that the emphasis of research in the area of risk has been on: (i) identifying risk factors for hospital admission and institutional placement, (ii) targeting older adults for specific programs, and (iii) evaluating the effectiveness of treatment programs for reducing or managing risk factors. There is a paucity of information on the subjective experience of risk from the perspective of the older adult. The purpose of this study was to describe the experience of older adults whose ability to live independently is threatened by the presence of one or more risk factors. The phenomenological perspective of qualitative research was used for this study. This approach seeks to study phenomena as they are experienced in everyday life. Individuals aged 65 or older were contacted through a Short Stay Assessment and Treatment Centre. A community health care professional used a risk factor screening tool to determine that participants were living “at risk.” Six individuals participated in the study. Data were collected from a range of sources including two unstructured interviews with each participant, documentary data sources and the researcher’s observations. Analysis of the data revealed that risk as a concept had meaning and utility for health care professionals only. It was discovered that what were “risk factors” and living “at risk” for the health care professional were interpreted as “losses” and coping with losses by the participants. Participants experienced four types of losses: the loss of functional abilities, loss of meaningful relationships, loss of meaningful activity and the loss of independence and control. These losses were perceived by participants as being irrevocable and interrelated. Furthermore, it was found that participants used a variety of strategies in coping with these losses. These strategies formed two distinct and opposing patterns: engaging and enduring. The findings also revealed that one particular risk factor, that is, a change in mental status, affected the nature of the data obtained in the study in that they were often scant and lacking in depth or richness. This finding has implications for conducting qualitative research with older adults experiencing such a change. Finally, the implications for nursing practice, education an research were identified in light of the findings.

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