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Approaches to resolve health challenges in a population of older adults undergoing hemodialysis.

Research is lacking regarding the health challenges older adults undergoing hemodialysis face when attempting to make lifestyle changes. The purpose of this study was to identify the health challenges of making lifestyle changes in this population and to identify approaches for resolving these challenges. Story theory guided data collection, and data were analyzed using Liehr and Smith's story inquiry method. Within these stories of health challenges, three themes captured the essence of what "matters most" to participants: (a) Living a Restriction-Driven Existence; (b) Balancing Independence/Dependence; and (c) Struggling With Those Providing Care. The approaches to resolving the health challenges exist on a continuum, with "unhappy passive acceptance" on one end and "assertive behavior intended to get what you want" on the other. The findings suggest that these approaches may change over time. Identifying health challenges could lead to self-management behaviors that support positive health outcomes for this population.