'Being' a ventricular assist device recipient :a liminal existence

Abstract

The purpose of this thesis is to illuminate the experience of living with a ventricular assist device (VAD) from the perspective of the recipients themselves, specific focus is given to the implications of the device on recipients’ day-to-day lives. VADs are mechanical circulatory devices that support or replace the function of a failing heart. In the UK, they are used to bridge patients to heart transplantation. This study adopts an interpretive phenomenological approach using the ‘lived experiences’ of VAD recipients as the basis of the investigation. The study comprised of twenty patients living with VADs, seventeen men and three women, aged 21 to 68, all of whom had been living on VAD support for varying amounts of time. A central tenet of this thesis is that the experience of ‘Being’ a VAD recipient is underpinned by a high degree of liminality (Turner, 1969). Life, for these individuals appears to be placed on hold whilst living with the device. Liminality creeps into the experience of ‘Being’ a VAD recipient at different time points, influencing how the individual views themselves and their future, the practices employed by VAD recipients to manage this uncertainty are considered. The impact of the materiality of the VAD is also discussed, with reference to literature from science and technology studies, exploring how recipients make sense of having a piece of technology implanted into the body and the resultant impacts on identity and surroundings following this merging of the ‘self’ and ‘not-self’. The impact of the VAD on recipients’ social roles and responsibilities are explored, along with the role of VAD communities in learning to live with the device. Ultimately, this thesis suggests that the essence of ‘Being’ a VAD recipient is a pervading sense of liminality as these individuals live under the lingering shadow of heart failure.