Participation and Independence in Old Age - Aspects of home and neighbourhood environments

University dissertation from Department of Health Sciences, Division of Occupational Therapy and Gerontology, Lund University, Sweden

Abstract: The current trend in Sweden is to support older people to remain living in their own homes as long as possible. Older people spend much of their daily life within the home and neighbourhood environment. It is well known that participation and independence is important in experiencing well being in old age. Thus from a health-promotion perspective it is interesting to uncover aspects within the home and neighbourhood environment that might relate to participation and independence in old age, in particular in very old age since resent research within this area is rather unexplored. Thus the overarching aim of this thesis was to explore old and very old people's participation and independence, focusing on aspects of home and neighbourhood environments. Public facilities in the neighbourhood important to visit were reported and a majority of problems in the neighbourhood environment were perceived along walking routes. Home was experienced as the locus and origin for participation and a signification of independence. Two dimensions of participation; Performance-oriented participation and Togetherness-oriented participation emerged and were statistically validated and objective as well as subjective home and neighbourhood variables were related the two dimensions of participation. The concept of independence was found to be a complex construct and there is a need of further explorations as regards the differentiation between independence and autonomy. The results of this thesis have further deepened the knowledge about very old peoples? own experiences of participation and independence as well as their relationships to the home and neighbourhood environment. The results are useful in future research on interventions on individual and societal level foremost in community-based occupational therapy.

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