Narratives of a Man With Severe Chronic Heart Failure and his Wife in Palliative Advanced Home Care Over a 4.5-year Period
Margareta Brännström
Department of Nursing and Department of Public Health and Clinical Medicine, Umeå University; Department of Medicine, Geriatric, Skellefteå County Hospital, Umeå, Sweden
Inger Ekman
Institute of Nursing, Sahlgrenska Academy, Göteborg University, Sweden
Kurt Boman
Professor, Department of Medicine-Geriatric, Skellefteå County Hospital; Department of Public Health and Clinical Medicine, Umeå University, Sweden
Gunilla Strandberg
Assistant Professor, Department of Nursing, Umeå University, Umeå, Sweden
PP: 10 - 22
Abstract
The aim of this paper is to illuminate meanings of living the ‘ups and downs’, through the narratives of one man with severe, chronic heart failure (CHF) and his wife in palliative advanced home care (PAHC). Narrative interviews were conducted over a 4.5 years period and a phenomenological-hermeneutic method was used to interpret the text.
The analysis resulted in one theme and four sub-themes. Meanings of living the ‘ups and downs’ is symbolically understood as being captive in a roller-coaster ride, side by side. In togetherness one helps one another to integrate the illness into everyday life. When, the inevitable ‘downs’ come one alleviate them as much as possible and/or just endure them waiting to see if one outlives them.
During the ‘ups’ one seizes every opportunity to live, doing the things one likes and discovering new possibilities in life. Sharing the safety belt on the ‘roller coaster’, offered by the PAHC team, evokes feelings of security. However, the safety belt is adjusted to the man with severe CHF leaving the wife without comfort and at times uncertain, especially in the deepest ‘downs’.
Our result indicates that the importance of medical treatment may increase over time. The ability to recognize symptoms and signs of deterioration may be facilitated by a trusted PAHC team’s repeated questions about the condition. Furthermore it is important to offer support directly to the close relatives.
Keywords
close relative, heart failure, home care, palliative care, patient, phenomenological-hermeneutic
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