October 19, 2007
Lorraine Holtslander, PhD student in Nursing
Photo by Colleen MacPherson.
By Brette Ehalt
Lorraine Holtslander, a PhD student in Nursing, can tell you just how powerful hope is.
After spending 14 years as a palliative home care nurse, Holtslander, well acquainted with the stresses and rewards experienced by the caregiver of a dying family member, wanted to know: how does the caregiver get through bereavement?
“Most family caregivers of advanced cancer patients are older women entering bereavement usually after an exhausting and difficult caregiving experience. I was searching for an insider’s perspective on the experience of hope for older women who are bereaved caregivers.”
Holtslander conducted 30 in-depth interviews with 13 women from Saskatchewan and asked each of them to complete hope diaries about their experiences; that is, to describe what hindered and helped their hope each day. The diaries revealed how participants “progressed along a figurative spiral” in their search for hope. As they progressed, Holtslander said participants sought to find new balance, perspective and purpose by relying on others for support, keeping busy, releasing pain, taking control, helping others and just being grateful, among other things.
There were hindrances to hope, as well, including loss of confidence, identity, purpose and future plans, she said. Specifically, participants struggled in their adjustment to living life alone – and with less financial security – and with society’s expectations for them to “move on.” One participant noted: “When you get at your lowest [hope] sometimes, you feel that way…[you] really don’t want to go on.”
Overall, hope is influenced by many factors and even the diaries themselves were a transformative resource in the participants’ lives. Holtslander concludes that “hope was critical to these women as they struggled to regain inner strength, build self-confidence, make sense of their situations, stay positive and move ahead with their lives.”
Holtslander will be presenting her findings at the Canadian Hospice Palliative Care Association National Conference Nov. 7 in Toronto. Ideally, health care professionals will apply her research by identifying bereaved caregivers as at risk for losing hope and by providing support to recognize their experience: to help them find release for painful emotions, offer guided journaling and appropriate referrals and provide encouragement to find hope in their own unique way.
According to Holtslander, there is some follow-up in place now, “but a more hope-focused program could offer strategies to specifically inform and foster hope.”
Holtslander, originally from Waldheim, is an assistant professor in the College of Nursing and is currently teaching a class on family diversity.
Brette Ehalt writes profiles of grad students for the College of Graduate Studies and Research.