A qualitative study of adaptation after deterioration in function in the elderly

Master Thesis

2015

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University of Cape Town

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The group studied were elderly people who had recently experienced an unexpected deterioration in their functioning, and who seemed to be coping well. It has been noted in the literature that many elderly continue to "age well" despite a setback to their health. The aim of this study was to understand and describe factors that participants had found useful in adapting to deterioration in health, so as to inform others going through a similar process, and health care workers who work with the elderly. This was a qualitative study conducted in a General Practice setting in Southern Suburbs of Cape Town. Nine semi-structured interviews were conducted. These were recorded and transcribed. Transcriptions were analyzed using Thematic Analysis. Analysis revealed a Core Theme, "In search of a new normal life", which described a process of transformation of aspects of themselves which participants needed to undergo in order to successfully deal with their new circumstances. Additionally, four Themes were identified that facilitated this transformation. These were "Groundwork" (preparation for old age), "Support" (family, friends and accepting help) , "Spirituality" (religious as well as existential wellbeing) and "Character" (key traits and attitudes). Overall, this study suggested that in order to continue to "successfully age" when health fails, a process of transformation of self seems to be necessary. Furthermore, it identified facilitating factors that may be able to be taught and learned. Importantly, the study also highlighted the shortcomings of the prevalent "Pathological Model" of health with respect to care of the elderly. The following implications for practice in caring for the elderly emerged from this study. One: Health care practitioners need to look beyond the biomedical model and remember the importance of spiritual, social and psychological dimensions that contribute towards living a meaningful life in older age. Two: Health care practitioners need to be aware of a transformative process that the elderly undergo in dealing with deteriorating function, and to assist in this process. Further research in this area to develop practical interventions, is recommended. Three: Based on the factors identified that facilitate transformation, health care practitioners need to educate their younger patients about what measures they can put in place to prepare for older age.
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