Chronic Illness and Conceptions of Self in Later Life: Continuity or Change?

Abstract

This thesis examines the processes by which the self-concept is shaped by chronic illness in later life. This study contributes to our understanding of the development of the self in later life by examining patterns of continuity and change. Twenty-four women diagnosed with osteoarthritis (0A) were interviewed. The participants were community dwelling females, aged between 67 to 85 years. They were selected to reflect a range of OA, from mild to severe forms of the disease. A qualitative approach, more specifically, the grounded theory method was adopted for this study. The findings illustrate that OA in later life presents a source of change for the self concept. However, the influence of these processes of change vary considerably. In particular, the significance of change for the self-concept is shaped by the individual's perception of the impact of chronic illness for the self. These are shaped by several factors. The impact of OA on the self is influenced by the ways in which the person's multiple identities are affected. And, the person's perception of continuity and change for her "overall" or global sense of self must be considered. Finally, the type of process mechanisms that are drawn upon shape the person's perception of continuity and change. Such processes include: shifting and non-shifting prominence hierarchies, the ability to adjust and accommodate to one's limitations and the extent to which interactions and valued identities are modified, social comparison, reflected appraisal, and the dialogue between the past, the present, and the future self. The data show that older people do reflect some of the same issues that have previously been revealed by studies of chronic illness which do not focus on later life. However, experiences of chronic illness in later life also present unique variations.