• J D Cortis and A Williams.
• School of Healthcare, University of Leeds, Leeds, UK. j.d.cortis@leeds.ac.uk
• Int Nurs Rev. 2007 Sep 1;54(3):263-70.

BackgroundChronic heart failure (CHF) affects older people and carries a heavy burden in terms of poor prognosis and quality of life. Palliative and supportive care services are being advocated in the UK to relieve that burden but older people's needs require further understanding to ensure effective service models.AimTo explore the experiences of older adults with CHF to gain a deeper understanding of their palliative and supportive needs and the value of possible interventions.MethodsThis qualitative study collected data from ten patients with CHF in New York Heart Association Classes II to IV, aged 80-90 years, attending a support programme. Semi-structured interviews were conducted and transcripts were analysed using constant comparative analysis.FindingsThe narratives revealed the consequences of living with heart failure in terms of physical symptoms and disability, psychological sequalae, social isolation and existential concerns. The variety of ways in which participants adjusted to and coped with these consequences was revealed in terms of their approach to their illness, and utilizing the resources available to them, including the support programme. Needs were conceptualized in terms of requirements to supplement deficits in coping resources.ConclusionsServices designed to meet palliative and supportive needs of older people should aim to identify individual coping strategies and resources and highlight deficits in order to target appropriate interventions.

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