November 08, 2007

Managing care in late life study by Case Western Reserve Researchers

From the College of Arts and Sciences and the Francis Payne Bolton School of Nursing


Some answers about the quality of life for older Americans will come from 125 remaining members of 1,000 retirees, who have been studied by Case Western Reserve University sociologist Eva Kahana over the past 18 years. The study's elderly participants have provided important information on how people lead successful lives as they cope with the stresses of growing older and frailer in the last years of life.

How the original study participants from Cleveland, Oh., and Clearwater, Fla., now 92 years old and older, and additional people in their 80s and 90s from Miami and Celebration, Fl., muster resources for what Kahana calls "care-getting," will provide one of the first in-depth looks at the social and personal aspects of everyday life for people entering the final phase of life.

Kahana will collaborate with May Wykle, dean of the Frances Payne Bolton School of Nursing at Case Western Reserve University, as the lead investigator in the $2.4 million, five year study funded by the National Institute of Health's National Institute of Nursing Research. Other university researchers on the project will be sociologists Jessica Kelley-Moore, a new faculty member, and Cathie King, project director.

"Care-getting is a new theory in aging that we have developed. It is also a key challenge in growing older," said Kahana, who is director of the Elderly Care Research Center in the sociology department at Case Western Reserve University and the Robson Professor of Sociology, Humanities, Nursing and Medicine.

From past findings, people, who are able to "marshal" resources for their needs, tend to cope better even when faced with the stresses of major health concerns, according to Kahana. She will see if that ability to access those supports in the earlier years carries through to later years and has an impact on the end quality of life.

In the past, the study's participants were contacted annually. The new funding enables the researchers to reach out to these individuals three times a year to gather detailed information through an extensive questionnaire about the course of their lives from volunteering, social activities, family relations and health concerns.

The researchers recently added a new component. They are looking at how technologies like cell phones and computers keep people connected for support from friends, neighbors, social services or health care providers in a ways that let people fulfill the needs of daily life and health care.

"Major gaps exist in our current knowledge of factors that contribute to maintaining comfort, sense of wellbeing and the meaningfulness during the final years and months of life," writes Kahana in a recent paper, "Care-Getting: Meeting the Ultimate Challenge of Aging Near the End of Life."

"I believe that the end of life is not need not be a period of complete dependency," said Kahana.

She added that care-getting may be the major task and goal to garner informal supports of family and friends and more formal help through the healthcare and social service systems for the very old.

She has found through her extensive interviews that people come to view death as part of living and are not afraid to die, but in the end, they do not want to suffer alone in an intensive care unit.

If someone has been a proactive person, she said, they have created the social supports around them who are knowledgeable about the person's wants and are able to speak when the individual can no longer give voice what they want.

Posted by: Heidi Cool, November 8, 2007 11:26 AM | News Topics: College of Arts and Sciences, Frances Payne Bolton School of Nursing, Grants, HeadlinesMain, Healthcare, Provost Initiatives, Research

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