The Meaning of Time in Oldest-Old Age

Dealing With Temporality in Patients With Life-Limiting Disease: An International Qualitative Study

The prospect of death influences people's thoughts about and how they deal with their remaining time. We aimed to understand whether patients with progressive, life-limiting diseases are oriented in the past, present, or future and how they deal with temporality. We conducted 57 in-depth interviews with end-of-life patients in 10 countries using thematic analysis at three levels (i.e., locally in three countries, with codes shared in the three-country subgroup, and in all 10 countries with a codebook that we developed). We found that the patients' thoughts were oriented toward all three time levels (i.e., past, present, and future). Complementing these levels, we identified another, namely, the future after death. Each time level included patients actively and passively dealing with their thoughts. Past themes were remorse and regret, nostalgia, and coming to terms with past choices; present themes were feeling grateful for being alive, a time for farewells, and living for the day; future themes were worries about the future, to miss out, hope, ideas about death and dying, and planning the near future; and future after death themes were not being there, worries about loved ones, and preparations for a future after death. A changed view on lifetime and avoidance of thinking about a certain time level related to several time levels, while desire to die fluctuated between levels and between acting on and feeling about it. Living for the day, worries about the future, and worries about the well-being of loved ones were common themes in all countries.

Older Adults’ Self-Perceptions of Aging and Being Older: A Scoping Review

Background and Objectives

Older adults’ self-perceptions of aging and being older can influence well-being and quality of life. This systematic scoping review aimed to map out current research on older adults’ self-perceptions of aging and being older.

Research Design and Methods

The scoping review followed Arksey and O’Malley’s methodological framework. A total of 5,037 records were identified (duplicates removed). After screening, a final 148 papers were included. Descriptives, including year of publication, methodology, age, gender, and location of participants, were calculated. Thematic analyses were conducted examining ways in which the topic was conceptualized.

Results

The most frequent method used in the research was quantitative. Participants were from 38 different countries. There were more female participants than male. Seven themes representing the main research emphasis emerged: attitudes towards one’s own aging (n = 48), aging well (n = 23), aging stereotypes, self-stigma (n = 23), construction of aging identities (n = 22), subjective age (n = 18), the aging body (n = 8), and future self-views (n = 6).

Discussion and Implications

The research within these themes approach self-perceptions of aging using varying points of reference for what participants compare their age to. The methods used to illicit aging perspectives held their own assumptions about aging.

A hermeneutic phenomenological explorations of living in old age

Although there have been some studies that explore the meaning of aging and give voice to older people, the impact that the aging experience can have on them justifies continued research in this area. In this study, with a hermeneutic phenomenological design and an interpretation method inspired by the philosophy of Ricoeur, we conducted in-depth interviews with 14 elderly people at a social day center in Rome (Italy). The analysis revealed three central themes associated with the experience of being old: changes and limitations related with being aged, the experience that comes from having lived a long life, and an awareness of death. The findings could help health professionals, families and caregivers to achieve a deeper understanding of what old age entails, and may also serve as a platform for interventions that seek to enable older people to experience aging as a meaningful and positive process.

"Embracing the present and fearing the future": the meaning of being an oldest old woman in a rural area

In Western countries, the number of older people receiving home nursing care is increasing, and in rural areas they are at additional risk because of the distance between people and health care facilities. The aim of this study was therefore to illuminate the meaning of being an oldest old woman living alone in a rural area and receiving home nursing care. A sample of 11 oldest old women living in rural areas in the middle of Norway was chosen for this study. Narrative interviews were conducted, and the data were analyzed using the phenomenological hermeneutic method. After a naïve reading and a structural analysis of the text, we identified four themes: being satisfied with life, being thankful, feeling vulnerable, and feeling secure. The comprehensive understanding implied that being an oldest old woman living alone in a rural area meant living in the intersection between embracing the present in solitude and fearing the future with additional declining health. Living in this complex situation meant to enjoy the present, but still fear the future, as the oldest old women knew their present life situations were limited. This challenging emotional situation meant using their inner strength by trying to be optimistic and seeing opportunities in present life, even if losses were many and extensive. By using their inner strength in facing losses and declining health, the oldest old women managed to appreciate aloneness as solitude, and find new meaning in life.

A concept analysis about temporality and its applicability in nursing care

TOPIC

Concept analysis of temporality.

PURPOSE

To develop a comprehensive definition of temporality applicable to nursing care.

SOURCE

Published literature.

CONCLUSIONS

Temporality is a central component of our experience of the world. Phenomena such as the passage of time, time cycles, the trajectory of aging, transitions toward something, something being, and life as a limited time are integral to human experience. Temporality could be seen as lived time, and as such it is subjective time as opposed to clock time or objective time. The temporal dimensions of past, present, and future constitute the perspective of a person's temporal world.

Ethical capital: 'what's a poor man got to leave?'

For those of little or no means, leaving one's mark through financial assets, social connections, and human investment is difficult. Using secondary analysis of transcripts from face-to-face interviews with 33 terminally-ill patients from an outpatient clinic at a public hospital serving the disadvantaged in the southern United States, we examine the legacy participants wish to leave behind. As part of this process, participants assess life circumstances to try and generate a legacy allowing them to remain personally relevant to loved ones after death. For the low-SES terminally ill persons in this study, the desire to leave a material legacy and the means to do so are not congruous. In the absence of economic resources to bequeath loved ones, participants describe their desire to leave loved ones some form of ethical currency to facilitate interactions with others and protect them against social marginalisation. We call this concept ethical capital. We then argue ethical capital is a way for disadvantaged people to find dignity and to affirm their lives.