Participation in everyday activities for elderly couples supported by short-term care homes
The starting point is that the number of older people is steadily increasing and that most older people want to be able to continue living at home as they age. The support of family members is very important when it comes to enabling older people to remain at home in ordinary housing.
Older couples' participation in everyday life - when living in changing contexts
The overall aim of the thesis was to explore and develop understanding of older couples' participation in everyday life when their context shifts through the use of short-term care. In order to answer the overall aim, several different perspectives were sought and different qualitative research methods were used. Data were generated through interviews and observations with older couples and through focus groups with caregivers, professionals and other stakeholders. Data were analyzed using constant comparative method, content analysis and narrative analysis.
The caregivers' perspectives are described in Study I, which showed that participation in everyday life involved both complexity and ambiguity. Having overall responsibility for everyday life was described by caregivers as challenging in many ways and created a need for recovery and personal time. Interactions with the social network and feeling secure with the social services offered, such as short-term care, were described as complex. The perception of the partner's well-being and participation, in turn, influenced the caregiver's conditions for their own participation when using short-term care. Study II described professionals' perspectives on older couples' participation in short-term care. Their picture of participation was both multifaceted and broad. The results showed how participation was promoted through trusting relationships, by enabling meaningful activities and by arranging a safe and shared environment. Study III explored the perspectives of older couples. The results showed that the couples strived to continue living their lives in an everyday community. Strategies used by the couples included redistributing responsibilities, doing more activities together than before, using short-term care, and reorganizing social contacts with family and friends. Multiple stakeholders' perspectives on the ideal situation for continued residence were explored in Study IV. The different actors described a need to focus on maintaining abilities and creating security for the older couples. Support is needed from both civil society and health care professionals. Furthermore, the professionals need to have the motivation, competence and time to do their work. The different actors also described that different forms of social services need to work together to ensure that resources in society are used and available.
In conclusion, this doctoral thesis contributes with in-depth knowledge about older couples' participation in everyday life when living in different contexts. The results showed the importance of paying attention to the couple's relationship and thus looking beyond the client and caregiver to support their participation in everyday life. Living in changing contexts was multifaceted and the couples strived to continue to live their lives in an everyday community. The impact of a changing living situation on the couples' participation in everyday life is important to consider in order to support their retention. To build a sustainable society in the face of demographic changes and challenges, it is essential to see the needs of older couples in the context of the needs and conditions of other stakeholders. In an ideal situation for older couples' continued residence, attention needs to be paid to societal functions and situations that both directly and indirectly affect older couples. Knowledge from this thesis work can be of value to occupational therapists and other health care professionals, as well as to different forms of social services that support older couples' residence. Consequently, this knowledge can benefit the life situation of older couples and their health and well-being when ageing at home.
Collaborators in the project:
- Gunilla Isaksson, professor of occupational therapy
- Margareta Lilja, professor emerita of occupational therapy
- Stina Rutberg, assistant professor of physiotherapy
- Jenni Riekkola Carabante, occupational therapist, MSc, PhD student (defended 2019)
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