Cancer Care From the Perspectives of Older Women

Abstract

PURPOSE/OBJECTIVES: To understand how older age affects cancer care, from the perspectives of older women. RESEARCH APPROACH: Qualitative, participatory. SETTING: Urban southern region of Ontario, Canada. PARTICIPANTS: Purposive sample (age groups and income) of 15 women diagnosed with cancer at age 70 or older; 10 women were diagnosed with breast cancer, 5 with gynecologic cancer. METHODOLOGIC APPROACH: Two face-to-face interviews, with data analysis in collaboration with the project team based on constructivist grounded theory, including negative case analysis. MAIN RESEARCH VARIABLES: Age, experience of cancer care. FINDINGS: Age-related life and health circumstances intersect with professional practice and wider social contexts and are implicated in treatment decision making, including decisions against treatment, as well as in the day-to-day "getting around" that cancer care requires. CONCLUSIONS: The nursing history should be holistic in scope, attending to the supportive care domains to elicit older women's physical, social, practical, informational, psychological, and spiritual needs after a diagnosis of cancer. History taking should draw forward older women's life contexts and examine these contexts in relation to cancer care, including treatment decision making. INTERPRETATION: Individual-level care and systems advocacy are required to ensure that older women's worries about sustaining independence, including worries generated by inadequacies in home-based care, do not act as determinants of treatment choices.