Sense of Coherence at End of Life in Older People: An Interpretive Description : Journal of Hospice & Palliative Nursing

Secondary Logo

Journal Logo

Feature Articles

Sense of Coherence at End of Life in Older People

An Interpretive Description

Gagne-Henderson, Rebecca PhD, APRN, ACHPN, FNP; Holland, Carol PhD, C.Psychol, AFBPS; Walshe, Catherine PhD, MSc, BNurs, RGN

Author Information
Journal of Hospice & Palliative Nursing 25(3):p 165-172, June 2023. | DOI: 10.1097/NJH.0000000000000948


As people age, losses accumulate (ie, the death of family and friends, the loss of agility, and the loss of independence). Such losses have an impact on one's Sense of Coherence, that is, one's ability to see the world as comprehensible, manageable, and meaningful. Antonovsky deemed Sense of Coherence as a mostly stable state by the age of 30 years. Until now, there has not been an investigation into how serial loss of resources affects older people as they near the end of life. Sense of Coherence was used as the theoretical framework for this study to answer the question of how older people maintain or regain a Sense of Coherence in the presence of serious illness as they near death. Data were gathered using semistructured interviews and guided by interpretive description. This investigation found new concepts that contribute to Antonovsky's midlevel theory of salutogenesis and the construct of Sense of Coherence. Those are Incomprehensibility and Serial Loss of General Resistance Resources. The results indicate that the crux of a strong Sense of Coherence for this population is excellent communication and a coherent “big-picture” conversation.

Copyright © 2023 by The Hospice and Palliative Nurses Association. All rights reserved.

You can read the full text of this article if you:

Access through Ovid