Social support along the cancer pathway: Older people's experiences

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Abstract

Cancer is predominately a disease of the older population and the recent changes in the cancer field, as a result of ageing, have been rapid and remarkable. Soon as many as one in two people will be diagnosed with cancer at some point in their life. Social support has been shown to have a positive effect on experiences of older people with cancer, however how social support creates a positive effect is still not clearly understood. To address this gap in knowledge, this PhD research explored older people’s experiences of social support along the cancer pathway. How social support could influence firstly treatment inequality experienced by older people with cancer, and secondly the quality of life of cancer survivors, was the primary focus of the research. The complexity of the topic, that is the interplay between cancer, older people, and social support, led to integrating qualitative and quantitative methods in a mixed methods design. The first phase of the research involved analysing stories from older people who had used advocacy services to gain support. Thematic analysis methods were applied to cancer narratives to gain a better understanding of the relationship between social support and treatment decisions made by older people with cancer. An exploratory sequential design was followed and the second phase of the research was directed by the findings from the qualitative research. Bivariate and multivariate regression analysis was carried out using data from the English Longitudinal Study of Ageing to gain greater understanding of the relationship between social support and quality of life of older people living with and beyond cancer. The qualitative findings highlighted emotional support needs relating to coping and loneliness. Although advocates were able to help in practical ways it was the emotional support provided though the act of being there that had the greatest impact. Most people reported high social support and had good quality of life (although cancer survivors on average had slightly lower quality of life compared to people without cancer). However, those who reported having low support or no support reported much poorer quality of life. The relationship was similar for both cancer survivors and older people without cancer. The findings potentially reflect complex situations (such as being a carer or not in stable accommodation) that can be adversely affected by also living with cancer. Interventions that increase social support, particularly through the act of ‘being there’ are likely to improve quality of life for older people living with cancer.

Keyword(s)

Cancer; ELSA; Mixed methods; Older people; Quality of life; Social support

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