An understanding of the end-of-life experience from the patient's perspective is limited. The prevailing approach to end-of-life care inquiry has been problem-oriented and much of the extant information about end-of-life care has been based on caregivers' retrospective reports and healthcare professionals' assumptions and clinical experiences. Identification of the deficiencies in care at the end-of-life and isolation of symptoms associated with advanced cancer have been the general focus.
Knowledge developed directly from the patient's perspective is needed in order to design meaningful care. This study was directed at knowledge development. To date, neither the notion of positive experiences related to the end-of-life nor the notion of living meaningfully through this final stage of life has been a research priority.
The purpose of this study was to explore the lived experience of approaching death among elderly persons with advanced cancer. The specific aim was to develop a better understanding of what elderly persons with advanced cancer experience as they approach death with a consideration for the breadth of the experience as well as the associated meaning. It is important that care be based on understanding; not merely healthcare professional's assumption or caregiver's retrospective reports, and that a more holistic approach rather than a solely problem-based approach be used. Only by knowing what it is like to live with advanced cancer can we fashion meaningful care for these individuals and those who love and support them.
A qualitative design with a phenomenological approach was used with five participants purposively selected from a hematology/oncology clinic in Kentucky. Multiple interviews were conducted over time with participants in their homes or a private hospital room.
The results elucidated the experience of approaching death due to advanced cancer for these five participants. Five insightful and compelling narratives of these individuals' experiences suggest that genuine caring, compassionate honesty from trusted healthcare professionals, cautious hopefulness maintained by the individual and their loved ones, unquestioned faith, an involvement in desired life activities, and positive interactions within the healthcare system and in their personal relationships were meaningful to this experience. Implications for healthcare professionals are included.
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