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.