“Elders in our study tend to view their work as a lifelong endeavour, and there is an ethic of stoicism with an attitude of ‘I can wait it out’ or not go to the hospital”, said Alex Clark, lead researcher on the study and a professor in the Faculty of Nursing at the University of Alberta in Edmonton, Canada.

The ongoing study is supported by the Alberta Centre on Aging. Research assistant Nicole Freydberg interviewed 30 patients 65 to 85 years old (70 per cent of them male), 24 unpaid caregivers including spouses and other family members, and 22 health professionals in rural communities in Alberta. Focus groups were also conducted with home care nurses in the health region.

During the interviews, patients were encouraged to retrace their illness experience, explore what their heart conditions meant to them, and identify both barriers and facilitators to managing chronic illness in a rural setting.

During this process, more than half of the patients recalled times when they had waited days for heart-related symptoms to subside, or gotten used to the discomfort and delayed seeking medical care until symptoms were severe.