Approaching death: a phenomenologic study of five older adults with advanced cancer.

PURPOSE/OBJECTIVES To explore the lived experience and the associated meaning of approaching death among older adults with advanced cancer. RESEARCH APPROACH A phenomenologic inquiry. SETTING Urban cancer center. PARTICIPANTS 5 individuals diagnosed with advanced cancer who were 65 years or older. METHODOLOGIC APPROACH A series of semistructured interviews were tape-recorded, transcribed verbatim, analyzed, and developed into narrative summations. FINDINGS The study elucidated the experience of approaching death from advanced cancer. The insightful and compelling narratives of five individuals' experiences suggest that genuine caring, compassionate honesty from trusted healthcare professionals, cautious hopefulness maintained by patients and their loved ones, unquestioned faith, an involvement in desired life activities, and positive interactions within the healthcare system and in personal relationships were meaningful to participants. CONCLUSIONS Knowledge developed from dying patients allows for an awareness that moves beyond assumption toward an in-depth understanding that can enable healthcare professionals to design meaningful care for these individuals. INTERPRETATION Knowledge gained directly from patients' experiences of what is meaningful and helpful as death approaches can guide effective interventions to improve palliative care practices and enhance overall quality of life while living with an incurable illness. Nurses have the ability to contribute meaningfully to patients facing death by relating to them with genuine care that acknowledges their humanity, conveying information with a compassionate honesty that recognizes the impact it will hold for patients and their loved ones, supporting patients' faith and cautious hopes, assisting patients in enjoying an active involvement in life within their limitations, and providing a safe and trusting environment in which to receive care.