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Understanding the experience of living well, beyond the age of 85 years: a qualitative analysis using themes from a meta-ethnography.

BACKGROUND
Increase in life-expectancy is not necessarily matched by an increase in quality of life.


OBJECTIVE
(1) To explore the quality of life of patients over the age of 85 in the second decade following unicompartmental knee replacement surgery (2) To understand the usefulness of a priori themes from an evidence synthesis as a framework for primary qualitative analysis.


DESIGN
Qualitative Research. A hermeneutic phenomenological approach, using a priori themes as sensitising concepts.


PARTICIPANTS
Adults over the age of 85 who were part of an outcomes study in the second decade following unicompartmental knee joint replacement.


METHODS
Semi-structured interviews in people's homes. Transcripts were coded and data sorted using a priori themes as sensitising concepts. Data that did not fit these themes, or that added nuance, were analysed thematically through constant comparison.


RESULTS
We interviewed seven white women and five white men, aged 85-100. Data resonated with a priori themes and supported additional themes that help us to understand older peoples' experience: (1) losing our autonomy can be challenging, so be kind; (2) we must take care of our own bodies and the NHS; (3) I am more afraid of not dying.


CONCLUSIONS
Findings indicate that health outcomes for older people should incorporate measures of participation and well-being; they highlight the importance of kindness in healthcare; they indicate that older people do not want to place additional burden on the NHS, and this can act as a barrier to care; they support the need for open conversations about dying well.