Meanings of life by the elderly terminally ill: an integrative review

Objective: To identify the existing knowledge about the meanings attributed to life by the elderly at the end of life. Method: Integrative literature review based on searches on the PubMed, Age Line, and the Virtual Library on Health (Bireme-VLH) databases, with a sample composed of at least 50% of the elderly, with progressive and life-threatening diseases refractory to treatment. Results: The study selected a total of 596 articles. After duplicates exclusion, selection by title, abstract, and complete reading, the study selected seven articles from 2001 to 2017, most of which were qualitative. The data analysis allowed us to identify two themes: sources of meaning and strategies to find meaning. The main sources of meaning were: significant relationships with the family, with oneself, with God, or with health professionals; the goodness/utility, valuing the good and the feeling of usefulness; spirituality/transcendence, in connection with God, nature, or higher energy; powerful, personal experiences, such as the contact with the internal strength and the ability to enjoy moments of pleasure and beauty. As strategies to find meaning, the study cites: religion and its belief systems; leaving a material or intangible legacy; internal dialogue; a sense of belonging. Conclusion: None of the studies included result from Latin American research, evidencing a lack of this theme in the studies in Brazil and its neighbor countries. Most of the articles describe oncological patients, indicating the need for research with non-oncological patients terminally ill. The findings aim to facilitate personalized attention to this patient profile, in particular by promoting attention to non-physical symptoms.