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Older people with incurable cancer: Existential meaning-making from a life-span perspective

Published online by Cambridge University Press:  11 June 2015

Sigrid Helene Kjørven Haug ,
Lars J. Danbolt ,
Kari Kvigne  and
Valerie DeMarinis
Sigrid Helene Kjørven Haug*
Affiliation:
Innlandet Hospital Trust, Center for Psychology of Religion, MF–The Norwegian School of Theology, Ottestad, Norway
Lars J. Danbolt
Affiliation:
Innlandet Hospital Trust, Center for Psychology of Religion, MF–The Norwegian School of Theology, Ottestad, Norway
Kari Kvigne
Affiliation:
Hedmark University College, Department of Public Health, Institute of Nursing and Mental Health, Elverum, Norway, and Nesna University College, Institute for Nursing Education, Nordland, Norway
Valerie DeMarinis
Affiliation:
IMPACT Research Program, Public Mental Health Promotion Area, Uppsala University, Sweden, and Innlandet Hospital Trust, Center for Psychology of Religion, Ottestad, Norway
*
Address correspondence and reprint requests to: Sigrid Helene Kjørven Haug, Innlandet Hospital Trust, Centre for Psychology of Religion, P.B. 68, 2312, Ottestad, Norway. E-mail: [email protected]
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Abstract

Objective:

An increasing number of older people in Western countries are living with incurable cancer, receiving palliative care from specialized healthcare contexts. The aim of our article was to understand how they experience the existential meaning-making function in daily living from a life-span perspective.

Method:

Some 21 participants (12 men and 9 women), aged 70–88, were interviewed in a semistructured framework. They were recruited from somatic hospitals in southeastern Norway. We applied the model of selective optimization with compensation (SOC) from life-span developmental psychology in a deductive manner to explore the participants' life-oriented adaptive strategies. A meaning component was added to the SOC model.

Results:

The participants experienced the existential meaning-making function on two levels. On a superordinate level, it was an important component for interpreting and coordinating the adaptive strategies of SOC for reaching the most important goals in daily living. The existential meaning-making framework provided for a comprehensive understanding of resilience, allowing for both restoration and growth components to be identified. The second level was related to strategy, in that the existential meaning-making function was involved in a complex interaction with behavioral resources and resilience, leading to continuation of goals and more realistic goal adjustments. A few experienced existential meaning-making dysfunction.

Significance of results:

The modified SOC model was seen as applicable for palliative care in specialized healthcare contexts. Employing the existential meaning-making framework with its complementary understanding of resilience as growth potential to the SOC model's restoration potential can help older people to identify how they make meaning and how this influences their adaptation process to being incurably sick.

Keywords

Palliative careGerontologySelective optimization with compensationExistential meaning-makingResilience
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 1 , February 2016 , pp. 20 - 32
Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

Allen, R.S., Haley, P.P., Harris, G.M., et al. (2011). Resilience: Definitions, ambiguities, and applications. In Resilience in aging: Concepts, research, and outcomes. Resnick, B. et al. (eds.), pp. 1–13. New York: Springer.Google Scholar
Alonso, M.A., López, A., Losada, A., et al. (2013). Acceptance and commitment therapy and selective optimization with compensation for older people with chronic pain: A pilot study. Behavioral Psychology/Psicologia Conductual, 21(1), 59–79.Google Scholar
Andersson, M., Hallberg, I.R. & Edberg, A.K. (2008). Old people receiving municipal care, their experiences of what constitutes a good life in the last phase of life: A qualitative study. International Journal of Nursing Studies, 45(6), 818–828.Google Scholar
Baltes, M.M. & Carstensen, L.L. (1996). The process of successful aging. Ageing and Society, 16(4), 397–422.Google Scholar
Baltes, P.B. (1993). The aging mind: Potential and limits. The Gerontologist, 33(5), 580–594.Google Scholar
Baltes, P.B. & Baltes, M.M. (1990). Psychological perspectives on successful aging: The model of selective optimization with compensation. In Successful aging: Perspectives from the behavioral sciences. Baltes, P.B. & Baltes, M.M. (eds.), pp. 1–34. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Baltes, P.B., Baltes, M.M., Freund, A.M., et al. (1999). The measurement of selection, optimization and compensation (SOC) by self-report: Technical report 1999. Materialien aus der Bildungsforschung Nr. 66. Berlin, Germany.Google Scholar
Baltes, P.B., Lindenberger, U. & Staudinger, U.M. (2006). Lifespan theory in developmental psychology. In Handbook of child psychology, 6th ed., Vol 1: Theoretical models of human development. Damon, W. & Lerner, R.M. (eds.), pp. 569–664. Hoboken, NJ: Wiley.Google Scholar
Cancer Registry of Norway (2014). Cancer in Norway 2012. Available from http://www.kreftregisteret.no/no/generelt/publikasjoner/cancer-in-Norway-2012.Google Scholar
Clark, P.G., Burbank, P.M., Greene, G., et al. (2011). What do we know about resilience in older adults? An exploration of some facts, factors, and facets. In Resilience in aging: Concepts, research and outcomes. Resnick, B. et al. (eds.), pp. 51–66. New York: Springer.Google Scholar
DeMarinis, V. (2008). The impact of post-modernization on existential health in Sweden: Psychology of religion's function in existential public health analysis. Archive for the Psychology of Religion, 30, 57–74.CrossRefGoogle Scholar
DeMarinis, V., Ulland, D. & Karlsen, K.E. (2011). Philosophy's role for guiding theory and practice in clinical contexts grounded in a cultural psychiatry focus: A case study illustration from southern Norway. World Cultural Psychiatry Research Review, 6(1), 47–56.Google Scholar
Donnellan, C. & O'Neill, D. (2014). Baltes' SOC model of successful ageing as a potential framework for stroke rehabilitation. Disability and Rehabilitation, 36(5), 424–429.Google Scholar
Donnellan, C., Hevey, D., Hickey, A., et al. (2012). Adaptation to stroke using a model of successful aging. Neuropsychology, Development, and Cognition. Section B: Aging, Neuropsychology, and Cognition, 19, 530–547.Google Scholar
Freund, A.M. & Baltes, P.B. (1998). Selection, optimization, and compensation as strategies of life management: Correlations with subjective indicators of successful aging. Psychology and Aging, 13(4), 531–543.Google Scholar
Freund, A.M. & Baltes, P.B. (2002). The adaptiveness of selection, optimization, and compensation as strategies of life management: Evidence from a preference study on proverbs. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57B(5), P426–P434.CrossRefGoogle Scholar
Gagliese, L., Jovellanos, M., Zimmermann, C., et al. (2009). Age-related patterns in adaptation to cancer pain: A mixed-method study. Pain Medicine, 10(6), 1050–1061.CrossRefGoogle ScholarPubMed
Gignac, M.A.M., Cott, C. & Badley, E.M. (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
Goldstein, M.E. & Morrison, S. (2005). The intersection between geriatrics and palliative care: A call for a new research agenda. Journal of the American Geriatrics Society, 53(9), 1593–1598.Google Scholar
Hall, S., Petkova, H., Tsouros, A.D., et al. (eds.) (2011). Palliative care for older people: Better practices. Copenhagen: WHOGoogle Scholar
Hammond, C., Teucher, U., Duggleby, W., et al. (2012). An “unholy alliance” of existential proportions: Negotiating discourses with men's experiences of cancer and aging. Journal of Aging Studies, 26, 149–161.Google Scholar
Hardy, S.E., Concato, J. & Gill, T.M. (2002). Stressful life events among community-living older persons. Journal of General Internal Medicine, 17(11), 841–847.Google Scholar
Haug, S.H.K., Danbolt, L.J., Kvigne, K., et al. (2014). How older people with incurable cancer experience daily living: A qualitative study from Norway. Palliative & Supportive Care, August 27, 1–12. Epub ahead of print.Google ScholarPubMed
Haugen, D.F., Jordhøy, M.S., Engstrand, P., et al. (2006). Organisering av palliasjon i og utenfor sykehus [Organizing inpatient and outpatient palliative care] [in Norwegian]. Tidsskrift for den Norske Legeforening, 126, 329–332.Google Scholar
Janke, C.M., Jones, J.J., Payne, L.L., et al. (2011). Living with arthritis: Using self-management of valued activities to promote health. Qualitative Health Research, 22(3), 360–372.Google Scholar
Lang, F.R., Rieckmann, N. & Baltes, M.M. (2002). Adapting to aging losses: Do resources facilitate strategies of selection, compensation, and optimization in everyday functioning. Journal of Gerontology, 57B(6), 501–509.CrossRefGoogle Scholar
Mundal, A. & Thonstad, M. (2013). Statistics Norway: Seks av ti eldre i kontakt med sykehus [in Norwegian]. In Eldres bruk av helse og omsorgsstjenester. Ramm, J. (ed.), pp. 77–83. Oslo: Statistics Norway. Available from http://ssb.no/helse/artikler-og-publikasjoner/attachment/125965?_ts=13f8b5b6898.Google Scholar
Nakashima, M. & Canda, E.R. (2005). Positive dying and resiliency in later life: A Qualitative study. Journal of Aging Studies, 19(1), 109–125.Google Scholar
Norwegian Directorate of Health (2013). Nasjonalt handlingsprogram med retningslinjer for palliasjon i kreftomsorgen [National Action Program with Guidelines for Palliative Care for Patients with Cancer] [in Norwegian]. Available http://www.helsedirektoratet.no/publikasjoner/nasjonalt-handlingsprogram-med-retningslinjer-for-palliasjon-i-kreftomsorgen-/Publikasjoner/nasjonalt-handlingsprogram-for-palliasjon-i-kreftomsorgen.pdf.Google Scholar
Ouwehand, C., de Ridder, D.T.D. & Bensing, J.M. (2007). A review of successful aging models: Proposing proactive coping as an important additional strategy. Clinical Psychology Review, 27, 873–884.Google Scholar
Pentz, M. (2008). Resilience among older adults with cancer and the importance of social support and spirituality-faith. Journal of Gerontological Social Work, 44(3–4), 3–22.Google Scholar
Piers, R., Pautex, S., Curale, V., et al. (2010). Palliative care for the geriatric patient in Europe. Zetschrift für Gerontologie und Geriatrie, 43(6), 381–385.Google Scholar
Rose, J.H., Radziewicz, R., Bowman, K.F., (2008). A coping and communication support intervention tailored to older patients diagnosed with late-stage cancer. Clinical Interventions in Aging, 3(1), 77–95.Google Scholar
Rush, K.L., Watts, W.E. & Stanbury, J. (2011 a). Older adults' perceptions of weakness and ageing. International Journal of Older People Nursing, 8(1), 1–9.Google Scholar
Rush, K.L., Watts, W.E. & Stanbury, J. (2011 b). Mobility adaptations of older adults: A secondary analysis. Clinical Nursing Research, 20(1), 81–100.Google Scholar
Rykkje, L.L.R., Eriksson, K. & Raholm, M.B. (2013). Spirituality and caring in old age and the significance of religion: A hermeneutical study from Norway. Scandinavian Journal of Caring Sciences, 27, 275–284.Google Scholar
Thygesen, E., Saevareid, H.I., Lindstrom, T.C., et al. (2009). Psychological distress and its correlates in older care-dependant persons living at home. Aging & Mental Health, 13(3), 319–327.CrossRefGoogle Scholar
Ulland, D. & DeMarinis, V. (2014). Understanding and working with existential information in a Norwegian adolescent psychiatry context: A need and a challenge. Mental Health, Religion & Culture, 17(6), 582–593.Google Scholar
Weiland, M., Dammermann, C. & Stoppe, G. (2011). Selective optimization with compensation (SOC) competencies in depression. Journal of Affective Disorders, 133, 114–119.Google Scholar
Wilhite, B., Keller, M.J., Hodges, J.S., et al. (2004). Enhancing human development and optimizing health and well-being in persons with multiple sclerosis. Therapeutic Recreation Journal, 38(2), 167–187.Google Scholar