Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T10:55:10.643Z Has data issue: false hasContentIssue false
  • English
  • Français

Accepting, active and in control: older women's experiences of ageing with peripheral arterial disease

Published online by Cambridge University Press:  16 July 2018

Kimberley Bassett ,
Judith Gullifer  and
Ramon L. Varcoe
Kimberley Bassett*
Affiliation:
School of Psychology, Charles Sturt University, New South Wales, Australia
Judith Gullifer
Affiliation:
School of Psychology, Charles Sturt University, New South Wales, Australia
Ramon L. Varcoe
Affiliation:
Department of Surgery, Prince of Wales Hospital, Sydney, Australia The University of New South Wales, Sydney, Australia
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

The population of Australia is ageing, with women being the primary beneficiaries of this increase in longevity. Increasingly older individuals are being diagnosed with different chronic illnesses such as peripheral arterial disease (PAD) which causes blockages of the blood vessels in the legs resulting in pain, non-healing ulcers, immobility and the potential amputation of the threatened limb. PAD has been traditionally thought to affect men more than women. Resultingly, women have been under-represented in clinical trials of PAD and under-diagnosed in the health-care setting. However, it has recently been acknowledged that women are indeed more likely to suffer from PAD than men due to increased presence of disease and survival advantage. As such, very little is known about women's understanding of and the meaning they create of their experiences of PAD. Therefore, how older women with PAD experience the ageing process is the focus of this qualitative research project. Interviews were conducted with 11 women from Sydney, Australia aged over 65 years who had been diagnosed with PAD. The interviews were analysed using an inductive thematic analysis. Three manifest themes were constructed: independence and control, active and involved, and the acceptance of ageing. These findings emphasised the idea that despite the presence of a chronic illness and increased age, remaining independent and engaged with life was vital to these women's wellbeing. Their subjective experiences of ageing reflect the fact that by adapting to the physical, mental and social changes that come with growing older, the focus does not need to be on loss and decline but rather can be about the continuation of life that can be both positive and meaningful.

Keywords

womenageingchronic illness
Type
Article
Information
Ageing & Society , Volume 39 , Issue 12 , December 2019 , pp. 2605 - 2630
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allison, MA, Ho, E, Denenberg, JO, Langer, RD, Newman, AB, Fabsitz, RR and Criqui, MH (2007) Ethnic-specific prevalence of peripheral arterial disease in the United States. American Journal of Preventive Medicine 32, 4, 328–333.Google Scholar
Aronow, WS (2007) Peripheral arterial disease in the elderly. Clinical Interventions in Aging 2, 4, 645–654.Google Scholar
Australian Bureau of Statistics (2012) Reflecting a Nation: Stories from the 2011 Census, 2012–2013 (2071.0). Canberra: Australian Bureau of Statistics. Available online at http://www.abs.gov.au/ausstats/[email protected]/lookup/2071.0main+features752012-2013 (Accessed 20 June 2015).Google Scholar
Australian Bureau of Statistics (2015) National Health Survey: First Results 2014–15. Canberra: Australian Bureau of Statistics. Available online at http://www.abs.gov.au/ausstats/[email protected]/mf/4364.0.55.001 (Accessed 4 September 2015).Google Scholar
Australian Institute of Health and Welfare (2012) Residential Aged Care in Australia 2010–11: A Statistical Overview. Catalogue number AGE 68, Canberra: Australian Institute of Health and Welfare. Available online at http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737422896 (Accessed 28 March 2015).Google Scholar
Australian Institute of Health and Welfare (2014) Australia's Health 2014. Catalogue number AUS 178), Canberra: Australian Institute of Health and Welfare. Available online at http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129548150 (Accessed 23 June 2015).Google Scholar
Baltes, MM and Carstensen, LL (1996) The process of successful ageing. Ageing & Society 16, 4, 397–422.Google Scholar
Baltes, PB and Baltes, MM (1990) Psychological perspectives on successful aging: the model of selective optimisation with compensation. In Baltes, PB and Baltes, MM (eds), Successful Aging: Perspectives from the Behavioural Sciences. Cambridge: Cambridge University Press, pp. 1–34.Google Scholar
Barochiner, J, Aparicio, LS and Waisman, GD (2014) Challenges associated with peripheral arterial disease in women. Vascular Health and Risk Management 10, 115–128.Google Scholar
Beal, C (2006) Loneliness in older women: a review of the literature. Issues in Mental Health Nursing 27, 7, 795–813.Google Scholar
Biggs, S (2005) Beyond appearances: perspectives on identity in later life and some implications for method. Journals of Gerontology: Psychological Sciences and Social Sciences 60B, 3, S118–S128.Google Scholar
Bowling, A (2009) Perceptions of active ageing in Britain: divergences between minority ethnic and whole population samples. Age and Ageing 38, 6, 703–10.Google Scholar
Braun, V and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 2, 77–101.Google Scholar
Bury, M (1982) Chronic illness as biographical disruption. Sociology of Health & Illness 4, 2, 167–182.Google Scholar
Buys, LR and Carpenter, L (2002) Cessation of driving in later life may not result in dependence. Australasian Journal on Ageing 21, 3, 152–155.Google Scholar
Carstensen, LL and Hartel, CR (2006) Motivation and behavioural change. In Carstensen, L and Hartel, C (eds), Committee on Aging Frontiers in Social Psychology, Personality, and Adult Developmental Psychology. Washington DC: National Academies Press, pp. 34–53.Google Scholar
Carstensen, LL, Turan, B, Scheibe, S, Ram, N, Ersner-Hershfield, H, Samanez-Larkin, GR, Brooks, KP and Nesselroade, JR (2011) Emotional experience improves with age: evidence based on over 10 years of experience sampling. Psychology and Aging 26, 1, 21–33.Google Scholar
Charmaz, K (1995) The body, identity, and self. The Sociological Quarterly 36, 4, 657–680.Google Scholar
Davidson, PM, DiGiacomo, M and McGrath, SJ (2011) The feminization of aging: how will this impact on health outcomes and services? Health Care for Women International 32, 12, 1031–1045.Google Scholar
Depaola, SJ, Griffin, M, Young, JR and Neimeyer, RA (2003) Death anxiety and attitudes toward the elderly among older adults: the role of gender and ethnicity. Death Studies 27, 4, 335–354.Google Scholar
DiGiacomo, M and Davidson, PM (2013) Australian women outlive men then struggle with disadvantage. The Conversation. Aailable online at http://theconversation.com/australian-women-outlive-men-then-struggle-with-disadvantage-12873 (Accessed 12 July 2015).Google Scholar
DiGiacomo, M, Lewis, J, Nolan, MT, Phillips, J and Davidson, PM (2013) Health transitions in recently widowed older women: a mixed methods study. BMC Health Services Research 13, 143, 1–10.Google Scholar
Emanuel, L, Bennett, K and Richardson, VE (2007) The dying role. Journal of Palliative Medicine 10, 1, 159–168.Google Scholar
Fowkes, FGR, Rudan, D, Rudan, I, Aboyans, V, Denenberg, JO, McDermott, MM, Norman, PE, Sampson, UKA, Williams, LJ, Mensah, GA and Criqui, MH (2013) Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. The Lancet 382, 9901, 1329–1340.Google Scholar
Fox, KR, Stathi, A, McKenna, J and Davis, MG (2007) Physical activity and mental well-being in older people participating in the Better Ageing Project. European Journal of Applied Physiology 100, 5, 591–602.Google Scholar
Gabriel, Z and Bowling, A (2004) Quality of life from the perspectives of older people. Ageing & Society 24, 5, 675–691.Google Scholar
Gawande, A (2014) Being Mortal. London: Profile Books.Google Scholar
Gibson, JM and Kenrick, M (1998) Pain and powerlessness: the experience of living with peripheral vascular disease. Journal of Advanced Nursing 27, 4, 737–745.Google Scholar
Gignac, MA, Cott, C and Badley, EM (2002) Adaptation to disability: applying selective optimization with compensation to the behaviors of older adults with osteoarthritis. Psychology and Aging 17, 3, 520–524.Google Scholar
Gott, MG, Seymour, JS, Bellamy, GB, Clark, DC and Ahmedzai, SA (2004) Older people's views about home as a place of care at the end of life. Palliative Medicine 18, 5, 460–467.Google Scholar
Hay, MC (2010) Suffering in a productive world: chronic illness, visibility, and the space beyond agency. American Ethnologist 37, 2, 259–274.Google Scholar
Heikkinen, R-L (2000) Ageing in an autobiographical context. Ageing & Society 20, 4, 467–483.Google Scholar
Heikkinen, R-L (2004) The experience of ageing and advanced old age: a ten-year follow-up. Ageing & Society 24, 4, 567–582.Google Scholar
Henderson, J (2001) ‘He's not my carer – he's my husband’: personal and policy constructions of care in mental health. Journal of Social Work Practice 15, 2, 149–159.Google Scholar
Hernandez-Vila, EA (2011) Peripheral arterial disease in women: the effect of gender on diagnosis and treatment. Texas Heart Institute Journal 38, 2, 154–156.Google Scholar
Hiramoto, JS, Katz, R, Weisman, S and Conte, M (2014) Gender-specific risk factors for peripheral artery disease in a voluntary screening population. Journal of the American Heart Association 3, 2, 1–9.Google Scholar
Hirsch, AT, Allison, MA, Gomes, AS, Corriere, MA, Duval, S, Ershow, AG, Hiatt, WR, Karas, RH, Lovell, MB, McDermott, MM, Mendes, DM, Nussmeier, NA and Treat-Jacobson, D (2012) A call to action: women and peripheral artery disease: a scientific statement from the American Heart Association. Circulation 125, 11, 1449–1472.Google Scholar
Hirsch, AT, Hartman, L, Town, RJ and Virnig, BA (2008) National health care costs of peripheral arterial disease in the Medicare population. Vascular Medicine 13, 3, 209–215.Google Scholar
Hirsch, AT, Haskal, ZJ, Hertzer, NR, Bakal, CW, Creager, MA, Halperin, JL, Hiratska, LF, Murphy, WR, Olin, JW, Puschett, JB, Rosenfield, KA, Sacks, D, Stanley, JC, Taylor, LM, White, CJ, White, J and White, RA (2006) ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients with Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation 113, 11, e463–e654.Google Scholar
Hitchcock, K (2015) Dear life: on caring for the elderly. Quarterly Essay 57, June, 1–78.Google Scholar
Holdcroft, A (2007) Gender bias in research: how does it affect evidence based medicine? Journal of the Royal Society of Medicine 100, 1, 1–3.Google Scholar
Howarth, G (1998) ‘Just live for today’: living, caring, ageing and dying. Ageing & Society 18, 6, 673–689.Google Scholar
Hummel, F (2008) Powerlessness. In Lubkin, IM and Larsen, PD (eds), Chronic Illness: Impact and Interventions. Eighth edition, Burlington, Massachusetts: Jones & Bartlett, pp. 315–342.Google Scholar
Hunter, DJ and Reddy, KS (2013) Non-communicable diseases. New England Journal of Medicine 369, 14, 1336–1343.Google Scholar
Hurd, LC (2000) ‘We're not old!’: older women's negotiation of aging and oldness. Journal of Aging Studies 13, 4, 419–439.Google Scholar
Huxhold, O, Miche, M and Schüz, B (2014) Benefits of having friends in older ages: differential effects of informal social activities on well-being in middle-aged and older adults. Journals of Gerontology: Psychological Sciences and Social Sciences 69B, 3, 366–375.Google Scholar
Jaff, MR, Cahill, KE, Yu, AP, Birnbaum, HG and Engelhart Luella, M (2010) Clinical outcomes and medical care costs among Medicare beneficiaries receiving therapy for peripheral arterial disease. Annals of Vascular Surgery 24, 5, 577–587.Google Scholar
Kahana, E, Bhatta, T, Lovegreen, LD, Kahana, B and Midlarsky, E (2013) Altruism, helping, and volunteering: pathways to well-being in late life. Journal of Aging and Health 25, 1, 159–187.Google Scholar
Kaufman, SR (1994) The Ageless Self: Sources of Meaning in Late Life. Madison, Wisconsin: University of Wisconsin Press.Google Scholar
Kent, JA, Patel, V and Varela, NA (2012) Gender disparities in health care. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine 79, 5, 555–559.Google Scholar
Lefebvre, KM and Chevan, J (2015) The persistence of gender and racial disparities in vascular lower extremity amputation: an examination of HCUP-NIS data (2002–2011). Vascular Medicine 20, 1, 51–59.Google Scholar
Levy, BR, Slade, MD, Kunkel, SR and Kasl, SV (2002) Longevity increased by positive self-perceptions of aging. Journal of Personality and Social Psychology 83, 2, 261–270.Google Scholar
Liles, DR, Kallen, MA, Petersen, LA and Bush, RL (2006) Quality of life and peripheral arterial disease. Journal of Surgical Research 136, 2, 294–301.Google Scholar
Mallers, MH, Claver, M and Lares, LA (2014) Perceived control in the lives of older adults: the influence of Langer and Rodin's work on gerontological theory, policy, and practice. The Gerontologist 54, 1, 67–74.Google Scholar
Marrett, E, Dibonaventura, M and Zhang, Q (2013) Burden of peripheral arterial disease in Europe and the United States: a patient survey. Health and Quality of Life Outcomes 11, 175, 1–8.Google Scholar
Martin, P, Kelly, N, Kahana, B, Kahana, E, Willcox, BJ, Willcox, DC and Poon, LW (2015) Defining successful aging: a tangible or elusive concept? The Gerontologist 55, 1, 14–25.Google Scholar
McCann Mortimer, P, Ward, L and Winefield, H (2008) Successful ageing by whose definition? views of older, spiritually affiliated women. Australasian Journal on Ageing 27, 4, 200–204.Google Scholar
Minichiello, V, Browne, J and Kendig, H (2000) Perceptions and consequences of ageism: views of older people. Ageing & Society 20, 3, 253–278.Google Scholar
Netz, Y, Wu, M-J, Becker, BJ and Tenenbaum, G (2005) Physical activity and psychological well-being in advanced age: a meta-analysis of intervention studies. Psychology and Aging 20, 2, 272–284.Google Scholar
Nguyen, L, Liles, DR, Lin, PH and Bush, RL (2004) Hormone replacement therapy and peripheral vascular disease in women. Vascular and Endovascular Surgery 38, 6, 547–556.Google Scholar
Nimrod, G and Hutchinson, S (2010) Innovation among older adults with chronic health conditions. Journal of Leisure Research 42, 1, 1–23.Google Scholar
Nowell, LS, Norris, JM, White, DE and Moules, NJ (2017) Thematic analysis: striving to meet the trustworthiness criteria. International Journal of Qualitative Methods 16, 1, 1–13.Google Scholar
Orfila, F, Ferrer, M, Lamarca, R, Tebe, C, Domingo-Salvany, A and Alonso, J (2006) Gender differences in health-related quality of life among the elderly: the role of objective functional capacity and chronic conditions. Social Science & Medicine 63, 9, 2367–2380.Google Scholar
Ouwehand, C, de Ridder, DT and Bensing, JM (2007) A review of successful aging models: proposing proactive coping as an important additional strategy. Clinical Psychology Review 27, 8, 873–884.Google Scholar
Perkins, MM, Ball, MM, Whittington, FJ and Hollingsworth, C (2012) Relational autonomy in assisted living: a focus on diverse care settings for older adults. Journal of Aging Studies 26, 2, 214–225.Google Scholar
Polkinghorne, DE (2005) Language and meaning: data collection in qualitative research. Journal of Counseling Psychology 52, 2, 137–145.Google Scholar
Productivity Commission (2013) An Ageing Australia: Preparing for the Future. Canberra: Productivity Commission. Available online at http://www.pc.gov.au/research/completed/ageing-australia/ageing-australia.pdf (Accessed 12 August 2015).Google Scholar
Quine, S and Morrell, S (2007) Fear of loss of independence and nursing home admission in older Australians. Health & Social Care in the Community 15, 3, 212–220.Google Scholar
Ranzijn, R and Luszcz, M (1999) Acceptance: a key to wellbeing in older adults? Australian Psychologist 34, 2, 94–98.Google Scholar
Regensteiner, JG, Hiatt, WR, Coll, JR, Criqui, MH, Treat-Jacobson, D, McDermott, MM and Hirsch, AT (2008) The impact of peripheral arterial disease on health-related quality of life in the Peripheral Arterial Disease Awareness, Risk, and Treatment: New Resources for Survival (PARTNERS) Program. Vascular Medicine 13, 1, 15–24.Google Scholar
Reichstadt, J, Sengupta, G, Depp, CA, Palinkas, LA and Jeste, DV (2010) Older adults’ perspectives on successful aging: qualitative interviews. American Journal of Geriatric Psychiatry 18, 7, 567–575.Google Scholar
Roberto, KA and McCann, BR (2011) Everyday health and identity management among older women with chronic health conditions. Journal of Aging Studies 25, 2, 94–100.Google Scholar
Rodham, K, Rance, N and Blake, D (2010) A qualitative exploration of ‘carers’ and ‘patients’ experiences of fibromyalgia: one illness, different perspectives. Musculoskeletal Care 8, 2, 68–77.Google Scholar
Rodin, J and Langer, EJ (1977) Long-term effects of a control-relevant intervention with the institutionalized aged. Journal of Personality and Social Psychology 35, 12, 897–902.Google Scholar
Rossen, EK, Knafl, KA and Flood, M (2008) Older women's perceptions of successful aging. Activities, Adaptation & Aging 32, 2, 73–88.Google Scholar
Rozario, PA, Kidahashi, M and DeRienzis, DR (2011) Selection, optimization, and compensation: strategies to maintain, maximize, and generate resources in later life in the face of chronic illnesses. Journal of Gerontological Social Work 54, 2, 224–239.Google Scholar
Russell, C (2007) What do older women and men want? Gender differences in the ‘lived experience’ of ageing. Current Sociology 55, 2, 173–192.Google Scholar
Ryff, CD (1989) Beyond Ponce de Leon and life satisfaction: new directions in quest of successful ageing. International Journal of Behavioral Development 12, 1, 35–55.Google Scholar
Sixsmith, J, Sixsmith, A, Fänge, AM, Naumann, D, Kucsera, C, Tomsone, S, Haak, M, Dahlin-Ivanoff, S and Woolrych, R (2014) Healthy ageing and home: the perspectives of very old people in five European countries. Social Science & Medicine 106, 1–9.Google Scholar
Smolderen, KG, Hoeks, SE, Pedersen, SS, van Domburg, RT, de Liefde, II and Poldermans, D (2009) Lower-leg symptoms in peripheral arterial disease are associated with anxiety, depression, and anhedonia. Vascular Medicine 14, 4, 297–304.Google Scholar
Stavroulakis, K, Donas, KP, Torsello, G, Osada, N and Schönefeld, E (2015) Gender-related long-term outcome of primary femoropopliteal stent placement for peripheral artery disease. Journal of Endovascular Therapy 22, 1, 31–37.Google Scholar
Steptoe, A, Shankar, A, Demakakos, P and Wardle, J (2013) Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences 110, 15, 5797–5801.Google Scholar
Stones, D and Gullifer, J (2014) ‘At home it's just so much easier to be yourself’: older adults’ perceptions of ageing in place. Ageing & Society, 36, 3, 449–481.Google Scholar
Szanton, SL, Walker, RK, Roberts, L, Thorpe, RJ, Wolff, J, Agree, E, Roth, DL, Gitlin, LN and Seplaki, C (2015) Older adults’ favorite activities are resoundingly active: findings from the NHATS study. Geriatric Nursing 36, 2, 131–135.Google Scholar
Terrill, L and Gullifer, J (2010) Growing older: a qualitative inquiry into the textured narratives of older, rural women. Journal of Health Psychology 15, 5, 707–715.Google Scholar
Treat-Jacobson, D, Halverson, SL, Ratchford, A, Regensteiner, JG, Lindquist, R and Hirsch, AT (2002) A patient-derived perspective of health-related quality of life with peripheral arterial disease. Journal of Nursing Scholarship 34, 1, 55–60.Google Scholar
Villar, F (2012) Successful ageing and development: the contribution of generativity in older age. Ageing & Society 32, 7, 1087–1105.Google Scholar
Walker, RB and Hiller, JE (2007) Places and health: a qualitative study to explore how older women living alone perceive the social and physical dimensions of their neighbourhoods. Social Science & Medicine 65, 6, 1154–1165.Google Scholar
Wann-Hansson, C, Hallberg, IR, Klevsgård, R and Andersson, E (2008) The long-term experience of living with peripheral arterial disease and the recovery following revascularisation: a qualitative study. International Journal of Nursing Studies 45, 4, 552–561.Google Scholar
Whitehead, BJ, Howie, L and Lovell, RK (2006) Older people's experience of driver licence cancellation: a phenomenological study. Australian Occupational Therapy Journal 53, 3, 173–180.Google Scholar
Wilkins, S (2001) Aging, chronic illness and self-concept: a study of women with osteoporosis. Journal of Women & Aging 13, 1, 73–92.Google Scholar
Woolhead, G, Calnan, M, Dieppe, P and Tadd, W (2004) Dignity in older age: what do older people in the United Kingdom think? Age and Ageing 33, 2, 165–170.Google Scholar
Workplace Gender Equality Agency (2014) Women's Economic Security in Retirement: Perspective Paper. Canberra: Workplace Gender Equality Agency. Available online at https://www.wgea.gov.au/sites/default/files/2014-03-04_PP_economicsecurity_0.pdf (Accessed 5 September 2015).Google Scholar