‘Independence’ among older people receiving support at home: the meaning of daily care practices

2017 ◽  
Vol 39 (3) ◽  
pp. 518-540 ◽  
Author(s):  
RACHEL BARKEN
Keyword(s):  
Older People ◽  
Qualitative Interviews ◽  
Later Life ◽  
Care Providers ◽  
Interpretive Analysis ◽  
Self Sufficiency ◽  
Formal Services ◽  
The Face ◽  
Care Practices ◽  
Physical Capacities

ABSTRACTLater life care practices are closely entangled with the ideals of independence and dependence. Based on an interpretive analysis of qualitative interviews with 34 people aged 65–100 receiving home care in Ontario, Canada, this article explores older people's subjective interpretations of caring for themselves (i.e. independence) and receiving support from others (i.e. dependence). Findings suggest that individuals construct subjective meanings of independence in relation to their changing physical capacities, and in the context of their relationships with family members, friends and formal care providers. First, participants considered their care activities to be a way of maintaining independence when they undertook certain practices with the intention of staving off dependency and future decline. Second, when they accepted assistance, many engaged in care relations that allowed them to preserve an independent identity in the face of limits to physical self-sufficiency. Third, participants reached the limits of independence when they lacked adequate assistance, and were unable to care for themselves in desirable ways. Findings illustrate how objective circumstances related to social and financial resources as well as access to formal services shape subjective interpretations, allowing some older people to hold on to independent identities while exacerbating feelings of dependency among others.

The temporal aspects of mobility intentions: older people's reflections on present and future support arrangements

2019 ◽  
pp. 1-21
Author(s):  
Rachel Barken
Keyword(s):  
Older People ◽  
Living Arrangement ◽  
Qualitative Interviews ◽  
Later Life ◽  
Ageing In Place ◽  
The Past ◽  
Interpretive Analysis ◽  
Health And Social Care ◽  
Temporal Aspects ◽  
Time Work

AbstractDiscourses on later-life housing and care are polarised. Ageing in place – typically in one's long-term dwelling – is often presented as the most desirable living arrangement, while moving to a congregate environment tends to be regarded as a last resort. Such polarised discourses obscure older people's experiences as they contemplate needs for housing, health and social care. To expand current understandings of mobility intentions, this paper examines ‘time work’ – or actions undertaken to exert some agency over time – as older people with chronic health conditions and disabilities navigate present and future support arrangements. Based on an interpretive analysis of qualitative interviews with 22 older persons receiving home care in Ontario, Canada, I identify three themes that highlight the temporal aspects of mobility intentions: (a) maintaining continuity with the past and present, (b) constructing alternative futures and (c) facing precarity. Focusing on time work shows how people make sense of ageing in place and/or relocating not only in relation to their physical, social and psychological capacities, but also in relation to perceptions of the past, present and future. Time work, moreover, has implications for feelings of security in the present and a sense of control over the future. Based on these findings, I make suggestions for developing a comprehensive continuum of supports, so all older people can make meaningful choices concerning housing and care.

scholarly journals Retirement Migration and Precarity: Material and Social Aspects

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 443-444
Author(s):  
Marion Repetti ◽  
Toni Calasanti
Keyword(s):  
Older People ◽  
Qualitative Interviews ◽  
Later Life ◽  
Social Aspects ◽  
Active Lifestyle ◽  
Retirement Migration ◽  
Material Resources ◽  
The Social ◽  
And Gender ◽  
The Impact

Abstract Discussions of precarity in later life have tended to focus on the uncertainties of material resources, and the feelings of anxiety that this evokes (e.g., Lain et al. 2019) as some older people thus face the risk of being excluded from the broader society. Although scholars often point to inequalities, such as those based on class and gender, as having an influence on the likelihood of older people experiencing such precarity, ageism is considered only to the extent that it can exacerbate the impact of these statuses through, for instance, labor market experiences. Here, we expand upon the impact of ageism on the social aspects of precarity: the loss of recognition and respect as a person that is at the core of social bonds. Drawing on qualitative interviews we have conducted among Swiss, British, and U.S. older people who migrated to cheaper countries in retirement, we demonstrate that ageism can influence precarity regardless of classes. We find that even among wealthier older migrants, who otherwise might fit the image of the retiree seeking an active lifestyle in a sunny location, the attempt to escape the devaluation heaped upon older people in their original country plays an important role. In their new countries, retired migrants of all classes felt that they were valued and part of a community, and this differed from the ageism in their home countries. We thus argue that ageism be considered in future analyses of precarity in later life.

scholarly journals Beyond BMI: a feasibility study implementing NutriSTEP in primary care practices using electronic medical records (EMRs)

2020 ◽  
Vol 40 (1) ◽  
pp. 1-10
Author(s):  
Lesley Andrade ◽  
Kathy Moran ◽  
Susan J. Snelling ◽  
Darshaka Malaviarachchi ◽  
Joanne Beyers ◽  
...  
Keyword(s):  
Primary Care ◽  
Eating Habits ◽  
Qualitative Interviews ◽  
Primary Care Providers ◽  
Early Years ◽  
Successful Implementation ◽  
Care Providers ◽  
Nutrition Risk ◽  
Care Practices ◽  
Primary Care Practices

Introduction Primary care providers have a role to play in supporting the development of healthy eating habits, particularly in a child’s early years. This study examined the feasibility of implementing the NutriSTEP® screen—a 17-item nutrition risk screening tool validated for use with both toddler and preschooler populations—integrated with an electronic medical record (EMR) in primary care practices in Ontario, Canada, to inform primary care decision-making and public health surveillance. Methods Five primary care practices implemented the NutriSTEP screen as a standardized form into their EMRs. To understand practitioners’ experiences with delivery and assess factors associated with successful implementation, we conducted semi-structured qualitative interviews with primary care providers who were most knowledgeable about NutriSTEP implementation at their site. We assessed the quality of the extracted patient EMR data by determining the number of fully completed NutriSTEP screens and documented growth measurements of children. Results Primary care practices implemented the NutriSTEP screen as part of a variety of routine clinical contacts; specific data collection processes varied by site. Valid NutriSTEP screen data were captured in the EMRs of 80% of primary care practices. Approximately 90% of records had valid NutriSTEP screen completions and 70% of records had both valid NutriSTEP screen completions and valid growth measurements. Conclusion Integration of NutriSTEP as a standardized EMR form is feasible in primary care practices, although implementation varied in our study. The application of EMR-integrated NutriSTEP screening as part of a comprehensive childhood healthy weights surveillance system warrants further exploration.

scholarly journals Pursuing security: economic resources and the ontological security of older New Zealanders

2013 ◽  
Vol 34 (10) ◽  
pp. 1666-1687 ◽  
Author(s):  
JULIANA MANSVELT ◽  
MARY BREHENY ◽  
CHRISTINE STEPHENS
Keyword(s):  
Older People ◽  
Life Experiences ◽  
Qualitative Interviews ◽  
Later Life ◽  
Economic Resources ◽  
Ontological Security ◽  
Strongly Connected ◽  
Material Conditions ◽  
Past Experiences ◽  
New Zealanders

ABSTRACTAccess to economic resources influences the material conditions of life for older people, as well as the freedoms and capacities of older people to achieve the kind of lives they value. Security is one aspect of later life valued by older people. Ontological security provides a sense of order and continuity and needs to be understood in terms of the situated life experiences and circumstances of older people. The study reported in this paper analysed 145 qualitative interviews with New Zealanders aged 63–93 in order to explore how participants understand ontological security. Varying levels of access to economic resources were associated with differing abilities of participants to manage the unpredictability of everyday life. Among the wealthy, security was strongly connected to the freedoms provided by ample financial resources. Contrary to what might be expected, those with the lowest levels of economic resources did not express higher levels of insecurity, but instead drew upon life experiences of managing and making do to construct a trajectory of security. Those with mid-range levels of economic resources expressed most insecurity, including anxiety over changing economic conditions and concerns over their ability to manage reductions in economic resources. In discussing the implications of this, the paper highlights the need to recognise ways in which access to economic resources intersect with life circumstances, past experiences and future social expectations to provide opportunities for all older people to pursue security as they strive to age well.

scholarly journals Lived experiences of ageing and later life in older people with intellectual disabilities

2013 ◽  
Vol 35 (3) ◽  
pp. 602-628 ◽  
Author(s):  
IDA KÅHLIN ◽  
ANETTE KJELLBERG ◽  
CATHARINA NORD ◽  
JAN-ERIK HAGBERG
Keyword(s):  
Older People ◽  
Lived Experience ◽  
Qualitative Interviews ◽  
Essential Element ◽  
Later Life ◽  
Phenomenological Approach ◽  
The Body ◽  
Analysis Method ◽  
Life World ◽  
People With Intellectual Disabilities

ABSTRACTThe aim of this article is to explore how older people with intellectual disability (ID), who live in group accommodation, describe their lived experience in relation to ageing and later life. The article is based on a study with a phenomenological approach, grounded on the concept of life-world. Individual, qualitative interviews were conducted with 12 people with ID (five men, seven women), between the ages of 48 and 71 (mean=64), who lived in four different group accommodation units in southern Sweden. A descriptive phenomenological analysis method was used, which disclosed a structure consisting of themes and sub-themes. The findings of the study reveal the informants' lived experience of ageing and later life as a multifaceted phenomenon, expressed through the two themes, ‘age as a process of change’ and ‘existential aspects of ageing’, each with three sub-themes. The body is an essential element in their experience of ageing and growing old, and in how this experience is expressed. The study also found social, cultural and historical dimensions of the life-world to be important in the informants' experience of ageing and later life. This supports understanding of the existence of a collective life-world for older people with ID, the unique experiences the informants share because of their disability and its consequences for their lifecourse.

scholarly journals Support for Older People in Households With Bare Branches in Rural China: Vulnerability, Dilemmas, and Possible Solutions

2019 ◽  
Vol 39 (11) ◽  
pp. 1213-1220
Author(s):  
Huijun Liu ◽  
Zhixin Feng
Keyword(s):  
Older People ◽  
Rural China ◽  
Qualitative Interviews ◽  
Later Life ◽  
Government Support ◽  
Shaanxi Province ◽  
Old Age Support ◽  
Older Parents ◽  
Social Security Benefits ◽  
Staying At Home

This study explored potential challenges and solutions for the support of older people among households with “bare branches” (unmarried men aged 28 years or older in rural China). Qualitative interviews were conducted in Ankang district of Shaanxi Province with 33 “bare branches” and 18 older parents of “bare branches.” Results showed that support from sons was still the main choice for older parents of “bare branches” in later life, and that most “bare branches” were the primary carers of their older parents. Older unmarried men faced a dilemma between staying at home to provide care to their parents, and migrating to cities to seek economic and marriage opportunities, and this was more common for unmarried men without a married brother. Government support is essential in relieving the challenges in old-age support faced by households with “bare branches”, such as developing social charities, training social workers, and improving social security benefits.

‘William’ and The Old Folks: Notes on Infantilisation

1996 ◽  
Vol 16 (4) ◽  
pp. 423-441 ◽  
Author(s):  
Mike Hepworth
Keyword(s):  
Older People ◽  
Age Groups ◽  
Later Life ◽  
Negative Consequences ◽  
Mature Adult ◽  
The Face ◽  
Adult World ◽  
Ageing Body ◽  
Older Men And Women ◽  
Selection Of

AbstractCritical concern with infantilisation practices—i.e. the tendency to treat older people as if they are dependent children—has for the most part concentrated on the negative associations between infantilisation and dependency in later life. Infantilisation is usually defined as an unwelcome imposition on older men and women who are often portrayed as relatively powerless to resist. Whilst the negative consequences of enforced infantilisation must not be ignored there are also occasions when infantilisation may be regarded as a voluntary or chosen mode of resistance on the part of older people to the decrements and external impositions of later life. The concept of infantilisation may therefore be enlarged to include modes of resistance involving processes of mutual identification of the old with the young; in certain instances even as a form of conspiracy between these two age groups against the wider society. This paper therefore pursues fictional images of such rapport as they occur in a selection of the ‘William’ stories written by Richmal Crompton during the period from 1919 up to her death in 1969, and with an appeal which continues up to the present day. The argument is that these stories of alliances between boyhood and ‘elders’ may be regarded as vivid examples (a repository of positive images) of what may be described as ‘positive infantilisation’: that is to say, of consciousness of the independence of subjective selfhood from the ageing body in the face of the misperceptions and misleading stereotypes of the ‘mature’ adult world.

The contribution of music to quality of life in older people: an Australian qualitative study

2005 ◽  
Vol 25 (2) ◽  
pp. 261-278 ◽  
Author(s):  
TERRENCE HAYS ◽  
VICTOR MINICHIELLO
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Personal Experience ◽  
Qualitative Interviews ◽  
Later Life ◽  
Self Esteem ◽  
Self Identity ◽  
Rural And Urban ◽  
Imaginative Play

This study examines the personal meaning and importance of music in the lives of older people, paying particular attention to the ways in which music contributes to self-identity and the quality of life. The data derive from qualitative interviews with a sample of older Australians aged 65 years and over who live in rural and urban settings. The findings reveal that music provides people with ways of understanding and developing their self-identity, of connecting with other people, of maintaining wellbeing and of experiencing and expressing spirituality, and that it provides strong associations with and memories of a person's life. Specifically, the results show how music is used as a source of entertainment as well as a forum to share and interact with others. Music was described as a personal experience to which people assigned meaning and emotions. The informants also described how music allowed them to engage in imaginative play and to escape from some of the hardships experienced in later life. The results reveal that music promotes quality of life by contributing to positive self-esteem, by helping people feel competent and independent, and by lessening feelings of isolation and loneliness. The paper argues that music can be used to maintain and promote a better quality of life for older people.

The meaning of the experience of anticipating falling

2014 ◽  
Vol 35 (9) ◽  
pp. 1839-1863 ◽  
Author(s):  
JAMES A. SHAW ◽  
DENISE M. CONNELLY ◽  
CAROL L. MCWILLIAM
Keyword(s):  
Risk Assessment ◽  
Older People ◽  
Health Care Providers ◽  
Fall Prevention ◽  
Fall Risk ◽  
Phenomenological Study ◽  
Later Life ◽  
Care Providers ◽  
Structured Interviews ◽  
Fall Risk Assessment

ABSTRACTFalling in later life continues to be a critical issue in gerontology research, health professional practice and ageing health policy. However, much research in the area of fall risk and fall prevention neglects the meaning of the experiences of older people themselves. This humanistic interpretive phenomenological study explored the meaning of the experience of anticipating falling from the perspective of older people in order to foster a more person-focused approach to fall risk assessment and fall prevention. Individual semi-structured interviews were conducted with nine participants over the age of 65 living independently in the community. Follow-up interviews with two key informants were completed to inform the emerging interpretations. For older participants residing in the community, the experience of anticipating falling meant confronting their embodied lived-identity in the context of ageing. Experiential learning shaped how participants understood the meaning of falling, which constituted tacit, pathic knowledge of vulnerability and anxiety with respect to falling. Findings emphasise the importance of critically reflecting on the social experience of anticipating falling to develop effective and relevant fall prevention interventions, programmes and policies. A lifeworld-led approach to fall risk assessment and fall prevention resonates with these findings, and may encourage health-care providers to adopt a sustained focus on embodied lived-identity and quality of life when engaging older people in fall prevention activities.

scholarly journals The difference an end-of-life diagnosis makes: qualitative interviews with providers of community health care for frail older people

2020 ◽  
Vol 70 (699) ◽  
pp. e757-e764
Author(s):  
Louisa Polak ◽  
Sarah Hopkins ◽  
Stephen Barclay ◽  
Sarah Hoare
Keyword(s):  
Health Care ◽  
Older People ◽  
Community Health ◽  
End Of Life ◽  
Community Care ◽  
Qualitative Interviews ◽  
Community Health Care ◽  
Care Provision ◽  
Care Providers ◽  
Frail Older People

BackgroundIncreasing numbers of people die of the frailty and multimorbidity associated with old age, often without receiving an end-of-life diagnosis. Compared to those with a single life-limiting condition such as cancer, frail older people are less likely to access adequate community care. To address this inequality, guidance for professional providers of community health care encourages them to make end-of-life diagnoses more often in such people. These diagnoses centre on prognosis, making them difficult to establish given the inherent unpredictability of age-related decline. This difficulty makes it important to ask how care provision is affected by not having an end-of-life diagnosis.AimTo explore the role of an end-of-life diagnosis in shaping the provision of health care outside acute hospitals.Design and settingQualitative interviews with 19 healthcare providers from community-based settings, including nursing homes and out-of-hours services.MethodSemi-structured interviews (nine individual, three small group) were conducted. Data were analysed thematically and using constant comparison.ResultsIn the participants’ accounts, it was unusual and problematic to consider frail older people as candidates for end-of-life diagnosis. Participants talked of this diagnosis as being useful to them as care providers, helping them prioritise caring for people diagnosed as ‘end-of-life’ and enabling them to offer additional services. This prioritisation and additional help was identified as excluding people who die without an end-of-life diagnosis.ConclusionEnd-of-life diagnosis is a first-class ticket to community care; people who die without such a diagnosis are potentially disadvantaged as regards care provision. Recognising this inequity should help policymakers and practitioners to mitigate it.

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