Older adults rarely face the stress of living with advanced cancer in a social vacuum. Partners and spouses are profoundly affected by, and contribute to the patient’s experience with illness. Partners provide the bulk of emotional and physical support and share in medical decision-making, treatment adherence and psychosocial adjustment. Psycho-oncology research primarily emphasizes the individual responses of patients and partners to illness. Relatively little empirical attention has been paid to the partner relationship, and less to older couples. This study examined the subjective and intersubjective experiences, and communication and support processes of 35 older couples living with advanced cancer. Data collected through focused, semi-structured interviews with patients and partners recruited from an urban cancer center were analyzed within individual, micro-social and macro- social contexts, and systematically coded using grounded theory methods. Study findings suggest couples struggle to integrate often-conflicting individual and dyadic discourses across three contextual domains: dyadic structure and care; dyadic communication; and dyadic meaning-making.

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