McWilliam CL, Ward-Griffin C, Oudshoorn A, Krestick E. Living while dying/dying while living: older clients’ sociocultural experience of home-based palliative care. J Hosp Palliat Nurs. 2008;10:338-4932
Finding 1	Conveyed full appreciation … in having the opportunity for more life (U)
Illustration	“Now that I am at the end of my life, I appreciate things much more than I did before. I appreciate life that I [previously] took for granted.”(p.341)
Finding 2	Celebrated the life they still had by living one day at a time (U)
Illustration	“[Life at present] means getting up in the morning and realizing I’m not dead! Saying, ‘Oh boy I’ve got a whole day of interesting stuff to do’.”(p.342)
Finding 3	Valuing time for one’s mortal being and enacting that through everyday experiences (U)
Illustration	“I’m energetic. I went for a nice walk yesterday and I’ve got electrolytes in my body … I want that life … This is important to me. I was supposed to be dead six months ago and here I am playing and enjoying life. It’s great!”(p.342)
Finding 4	Failure to materialize “normal” everyday life activities … brought the experience of “dying while living” to the forefront (U)
Illustration	“You know, I need to get out or it is going to kill me … I’m dying slowly. I can feel it, not because of the cancer, but because of not being mobile, you know.”(p.342)
Finding 5	Falling outside the margins of everyday life meant that dying was experienced as an isolated inhuman experience (U)
Illustration	“Some days I don’t feel too good,”… “It’s just like being on death row … you know, you’re waiting, but you know that things are not going to get that much better.”(p.342)
Finding 6	Focused on retaining one’s physical being as long as possible (U)
Illustration	“I’m not counting the days, you know, because I know if I’m counting the days it is faster to the end of my life.”(p.345)
Finding 7	Being unable to participate in everyday life activities left study participants feeling marginalized (U)
Illustrations	“I am ill, I feel like a burden to other people … they try and call, because [names self] is sick, you know, and that … bugs me.”(p.342)
Finding 8	‘Dying while living’ was repeatedly emphasized (U)
Illustration	“Like a man being sentenced to be executed, that’s what I felt. That’s what I felt the first time the doctor told me I’m going to die in six months. I thought that … I’m going to be executed … That’s how I feel … I am being sentenced to death.”(p.342)
Finding 9	Disease and its treatment continuously notified the senior that his/her “self” was mortified (U)
Illustration	“I would have rather had a damn heart attack than cancer. You know … a heart attack … and die. But this, this disease that I have got, it, it’s only prolonging my life it seems. So, I know that I am going to die, but it’s taking its toll, taking its time. If I could change that … I would rather die today … than just go on and on and on … with chemo … and stuff like that … I’ve never been so violated.”(p.342)
Finding 10	Experienced intense existential intrapersonal isolation and aloneness … to be part of confronting death (U)
Illustration	“You think about it … What good am I on this earth? What am I doing here? You know … why do they prolong people’s lives? Why? What’s the purpose? … The fundamental things in life you can’t even do … So what good are you? You can’t … walk. You can’t eat a proper meal. You can’t have … sex. What good is this? You’re just sitting around. And for what? Waiting for the day to come when you die … It’s very difficult!”(p.342-3)
Finding 11	Focused effort to “connect” … they gave care to their loved ones (U)
Illustration	“We’re concerned about the happiness of the other, and … that impending death affects that. You know you might as well try and make your spouse happy while you’re still here.”(p.343)
Finding 12	Prepared their loved ones for being on their own (U)
Illustration	“When he [her husband] is down [emotionally], he will kind of tell me … all of the finances I have discussed with him, because I looked after all that. And I have trained him how to use the phone service … the files that I filed … how to do the email, and how to use the web … how to wash clothes properly so the black is not in with the white … I think, I’m at the point I can see that he will survive without me.”(p.343)
Finding 13	Placed high value on their interpersonal relationships, normalizing relationships through social reciprocity (U)
Illustration	“You have to give and receive, you can’t just take, take, take. You have to give also.”(p.343)
Finding 14	Experiences of being connected with their nurses were in keeping with their sick role (U)
Illustration	“When she came and I had so much pain, and she held my hand after she gave me the needle, those things mean a lot, you know, the touch.”(p.343)
Finding 15	Appreciation for continuity in the relationships with palliative care nurses (U)
Illustration	“She [palliative care nurse] is very warm and nice, and I felt the only way to appreciate her warmness and kindness was to give her a hug … Sometimes I don’t give a hug. But I really … love that woman.”(p.343)
Finding 16	Handed over their personal roles to those who would outlive them (U)
Illustration	“I don’t work too much. I used to do the hangers … like the clothes closet … But somebody else had to take over. I told them I had resigned from that job.”(p.343)
Finding 17	Detaching and withdrawing from others (U)
Illustration	“I … know how other people feel now to come and see me. I don’t want them to come and see me anyway.”(p.344)
Finding 18	Social isolation from other individuals as a function of … conflicted feelings … withdrawal from activities and social interactions (U)
Illustration	“A lot of things aren’t important to me anymore. I particularly do not want to see a lot of people. I want to be alone, but then, I do not want to be alone.”(p.344)
Finding 19	Detaching sometimes was extended to their palliative care nurses (U)
Illustration	“I’m sick of people touching me, strange people … I just can’t handle it anymore.”(p.344)
Finding 20	Significant others initiated the detachment, marginalizing the dying individual (U)
Illustration	“You know … two of my best friends … I absolutely love them, and when I told her [that I was dying], she said, ‘I cannot deal with it,’ and she never phoned me … It really hurts when you care for people and then they drop you.”(p.344)
Finding 21	Recognizing but simultaneously resenting their illness … begrudging the passing of their lives (U)
Illustration	“I know the demon cancer is still there … and it’s a hell of a thing … You know you’re going to die, you know the damn thing is going to kill you.”(p.344)
Finding 22	Appreciation of the opportunity to have time to prepare for their death (U)
Illustration	“I mean, we are all dying, [I’m] only somebody who is predetermined a little bit earlier … I’m glad I know [that I am dying]. I feel like I can get everything ready.”(p.344)
Finding 23	Lived every day as though it might be the last, focusing on making it a positive and purposeful time (U)
Illustration	“What matters is right now, this moment, this life.”(p.345)
Finding 24	Within their medicalized in-home palliative care context … they explained their effort to “hold on” to normal physical and social life, despite their sick role (U)
Illustration	“I don’t … feel as good as I did … after my surgery … But I’m not too bad. Just a day at a time … that’s all, you know. If I feel good, I go out and around. And if I’m not, I just stay around and … try to amuse myself in here.”(p.345)
Finding 25	Reached out to their loved ones, reassuring them of their potential to transcend mortality (U)
Illustration	“I try to tell him [husband] I’m not too worried about dying, because I always believed in angels …and I always believed that something else is going to be there.”(p.345)
Finding 26	Moved beyond equating their lives to mortal being and spoke positively about their “life after life” (U)
Illustration	“I’m not worrying about tomorrow … Whatever happens tomorrow, the good Lord will take care of me … I’m OK … if I have to [die]. This world is not my home [laughs].”(p.346)

U, unequivocal.