Dying with dignity – Dignity-preserving care for older women living with incurable cancer at home

Background: the global population is ageing rapidly and most older people are women. They live longer than men, report more illnesses and have a poorer health status. When living with incurable cancer, gender perspectives and dignity should be emphasized within the care for older women, so as to fulfil their complex needs. Aim: the aim of this project was to develop an empirical-theoretical model, based on the identification and documentation of experiences related to dignity and dignity loss among older women living with incurable cancer at home. Methods: this thesis comprises individual in-depth interviews, focus group interviews and participant observations with home-dwelling women, living with incurable cancer, ICs and HCPs. A hermeneutical methodology was chosen for this research project, and Katie Eriksson’s Theory of Caritative Caring was allocated as a theoretical foundation to interpret the findings. Results: the women experienced dignity when feeling valued as individuals, having a sense of control in life and living in safe environments, where they were able to remain hopeful and find meaningfulness. A flexible, organizational culture of care contributes to a functional, professional collaboration, facilitating HCPs to provide dignity-preserving care for these older women. Dignity loss was identified when the women experienced a loss in terms of human value and the opportunity for self-determination. They experienced a sense of disconnection and alienation within their surroundings, when not being treated with gentleness and flexibility by others. Conclusion: being confirmed and recognized as a worthy human being, when experiencing suffering, results in the older women experiencing dignity. Having a sense of physical and existential control in life, was crucial to shelter human dignity. When being invited into a caring communion by HCPs, the women felt a sense of at-homeness in safe and sheltered surroundings. Finally, when experiencing hope and dignity in their lives, they achieved optimal health and an inner peace when nearing end-of-life. On this basis, an empirical-theoretical Model of dignity-preserving care for older home-dwelling women with incurable cancer, has been developed.Doktorgradsavhandlin