The future is the present: diabetes complication stories

pilon r, bailey ph, montgomery p & bakker d (2011) Journal of Nursing and Healthcare of Chronic Illness3, 234–244The future is the present: diabetes complication stories Aim. The aim of this study is to address the core question: what are rural older adults’ stories about type 2 diabetes-associated complications? Background. The majority of older adults living with diabetes have type 2 diabetes; a progressive illness characterised by high blood glucose and microvascular and cardiovascular changes. This pathology increases the risk for diabetes-associated complications in the older adult. Some authors contend that the qualitative work to date has not yet captured the complexities of living with and managing a chronic illness such as diabetes. Methods. Fifteen older persons living in a rural community participated in a focused ethnographic research design guided by a narrative perspective. Data were collected in 2008. Findings. The participants, ranging in age from 66–84 years, told 72 stories about diabetes-associated complications. Although many of them did not acknowledge the presence of diabetes-associated morbidities, their stories shared a common structure demonstrating a vicarious interpretation of this experience. Conclusions. Participants’ accounts of managing their illness located their future in their present reality –‘the chase’ from inescapable illness circumstances. Despite their best efforts to control their illness, all participants envisioned that complications would eventually win out. Relevance to clinical practice. The self-perception of older persons with type 2 diabetes vacillates in relation to the presentation of complications. This continuous self-restructuring contributes to the complexity of shared illness management and demands that healthcare providers strive to understand the older persons’ psychosocial context of the illness experience.