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Experiences of community-dwelling older adults living with multiple chronic conditions: a qualitative study
  1. Jenny Ploeg1,
  2. Marta Canesi2,
  3. Kimberly D Fraser3,
  4. Carrie McAiney4,
  5. Sharon Kaasalainen5,
  6. Maureen Markle-Reid1,
  7. Sinead Dufour6,
  8. Lisa Garland Baird3,
  9. Tracey Chambers1
  1. 1 School of Nursing, Aging, Community and Health Research Unit, McMaster University, Hamilton, Ontario, Canada
  2. 2 School of Nursing, Universita degli Studi di Milano-Bicocca, Milano, Lombardia, Italy
  3. 3 Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
  4. 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
  5. 5 School of Nursing, McMaster University, Hamilton, Ontario, Canada
  6. 6 School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to Dr Jenny Ploeg; ploegj{at}mcmaster.ca

Abstract

Objectives The aim of the study was to understand the experiences of living with multiple chronic conditions (MCC) from the perspective of community-living older adults with MCC.

Design A qualitative study using an interpretive description approach.

Setting Participants were recruited from southern Ontario, Canada.

Participants 21 community-living, older adults (≥65 years) with an average of 7.4 chronic conditions including one of diabetes, dementia or stroke.

Methods Data were collected through digitally-recorded, in-depth, semi-structured in-person interviews. Interview transcripts were analysed and coded using Thorne’s interpretive description approach.

Results Five themes were identified representing older adults' experiences of living with MCC: (a) trying to stay healthy while living with MCC, (b) depending on family caregivers for support with just about everything, (c) paying the high costs of living with MCC, (d) making healthcare decisions by proxy and (e) receiving healthcare services that do not address the complex needs of persons living with MCC.

Conclusions The experience of living with MCC in the community was complex and multi-faceted. The need for a person-centred and family-centred approach to care in the community, which includes the coordination of health and social services that are tailored to the needs of older adults and their informal caregivers, was underscored. Such an approach would facilitate improved information-sharing and discussion of care management options between health professionals and their patients, enable older adults with MCC to actively engage in priority-setting and decision-making and may result in improved health and quality of life for older adults with MCC.

  • primary care
  • qualitative research
  • multimorbidity
  • older adults
  • home care services
  • interpretive description

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors JP and MM-R obtained funding for the project. JP and KDF conceived of the project, wrote the protocol and obtained ethical approval. JP supervised the overall project. MC, JP and TC analyzed the data. MC wrote the first draft of the manuscript. JP, MC, KDF, CM, SK, MM-R, SD, LGB, and TC reviewed and approved the final manuscript. All authors meet ICMJE criteria for authorship.

  • Funding This study is part of a program of research (Aging, Community and Health Research Unit, School of Nursing, McMaster University), supported by the Canadian Institutes of Health Research Signature Initiative in Community-Based Primary Healthcare (http://www.cihr-ircs.gc.ca/e/43626.html) (Funding Reference Number: TTF 128261) and the Ontario Ministry of Health and Long-Term Care Health System Research Fund Program (Grant #06669). MM-R was also supported through the Canada Research Chairs Program, as the Chair in Aging, Chronic Disease and Health Promotion Interventions.

  • Competing interests None declared.

  • Ethics approval The study was approved by the Hamilton Integrated Research Ethics Board (#13-411) in Hamilton, Ontario, Canada.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data for this research consist of in-person interview transcripts. Raw data cannot be publicly released due to the risk of compromising participant confidentiality.

  • Patient consent for publication Not required.

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