Accessing health services: the experience of elderly rural couples

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The goal of elderly rural couples is to continue in their shared existence and remain together in a home of their choosing for as long as they believe they can manage. Couples identified access to health services among the resources contributing to the achievement of that goal. Six elderly couples residing in their own homes in rural communities of less than 3000 people in southwestern Manitoba participated in conjoint conversational interviews to describe in detail and give meaning to their personal experiences in accessing health services. The research approach was based upon the phenomenological methodology of Max van Manen (1997). The couple was the unit of inquiry, the couple experience the focus of interest and the conjoint interview the method of research. During a series of interviews over a seven-month period, the couples ' conversations and stories described their lives, providing insight into their experiences in accessing health services and other resources, their long-term dyadic relationships, the issues of daily living that they encountered during their interdependent lives, and their adaptability, decision-making and problem-solving capacities as they managed the changes and challenges that influenced their worlds. A descriptive theoretical couple-environment reciprocity framework for adaptation to change resulted. The decision-making and problem-solving processes used by the couples were identified as significant to the reciprocity and adaptation. Refocusing from individual spousal caregivers or care receivers to the couple as a unit has implications for creative and more appropriate program planning and policy development. The better nurses and other health professionals are able to describe and understand elderly rural couples and their access to health services, their struggles to remain together, and their decision-making and problem-solving practices, the better able they will be to provide care and support to them, plan programs and services with them, conduct research to answer questions of importance to them, and contribute to the development of healthy public policies that sustain rural seniors ' autonomy and quality of life.
Bibliography: p. 169-184
Racher, F. E. (2003). Accessing health services: the experience of elderly rural couples (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from doi:10.11575/PRISM/21984