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Heart Failure in the Oldest Old: A Qualitative Case Study on Patients` Perception of and Communication about Illness and Prognosis
Katharina Klindtworth1*, Martina Pestinger1, Peter Oster2, Klaus Hager3 and Nils Schneider41Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research, Hanover, Germany
2AGAPLESION Bethanien Hospital, Geriatric Centre at the University, Heidelberg, Germany
3Diakoniekrankenhaus Henriettenstiftung, Clinic for Medical Rehabilitation and Geriatrics, Hanover, Germany
4Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research and Institute for General Practice, Hanover, Germany
- *Corresponding Author:
- Katharina Klindtworth
Hannover Medical School
Institute for Epidemiology
Social Medicine and Health Systems Research
Hanover, Germany
E-mail: klindtworth.katharina@mh-hannover.de
Received date: October 29, 2012; Accepted date: November 23, 2012; Published date: November 26, 2012
Citation: Klindtworth K, Pestinger M, Oster P, Hager K, Schneider N (2012) Heart Failure in the Oldest Old: A Qualitative Case Study on Patients` Perception of and Communication about Illness and Prognosis. J Palliative Care Med 2:134. doi:10.4172/2165-7386.1000134
Copyright: © 2012 Klindtworth K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Heart failure has a poor long-term prognosis and causes high burden of disease. The aim of this study was to gain an in-depth understanding how elderly patients with advanced heart failure perceive and communicate their illness. We carried out a longitudinal case study of two patients (female, 86 and 95 years old, heart failure NYHA III/IV, different social settings) with a total of eight qualitative interviews, covering a period of nine months. The interviews were analyzed using both coding and a narrative approach. Both patients were poorly informed about heart failure and its prognosis. The patients` major concerns were centered more on organizational issues than on emotional aspects concerning death and dying. Summarized, open discussion of end-of-life issues is difficult in elderly patients with advanced heart failure. Advance care planning could be an appropriate strategy to improve communication and delivery of health and social care.
