Participation in everyday life. Very old persons' experiences of daily occupation, occupation of interest and use of assistive devices

Abstract: The overall aim of the present thesis was to examine, extend and deepen the understanding of very old persons? experience of participation in everyday life from an occupational perspective. The thesis consists of four empirical studies. The participants are mainly very old persons (80+) living at home and were derived from the gerontological and geriatric population studies in Göteborg (H70), Sweden. Study I (n=11) and study IV (n=10) are qualitative studies in which a phenomenographical approach was adopted. Study II is a cross-sectional study (n=205), and study III is a cross-sectional and longitudinal study (n=201), which were subjected to qualitative content- and statistical analysis. The findings in study I and II showed that very old persons used assistive devices to a high degree, and that the use of devices increased with age. Most common were devices used in hygiene- and mobility related occupations. The experiences of being a user of assistive devices varied greatly and various contradictions were found. On the one hand, the assistive devices were seen as natural or normal for the age, the devices gave support, made the person feel safe and facilitated their daily occupation. On the other hand, the assistive devices were experienced as cumbersome, gave a feeling of incapability, were a mark of old age, and made the person concerned avoid participation in everyday life. The findings in III study showed that the participants had a broad range of occupations of interest, media and individual leisure interests being the most common. Personal and environmental factors were reasons for giving up interests. Persons who regarded their health as good, or had no problems in daily activities or in mobility outdoors, had more interests than those with poor health, limited abilities in mobility and in managing daily occupations. The findings in study IV showed how 99-year old persons regarded themselves as competent and proud of their ability to participate in everyday life. Many signs of involvement in daily occupations were found; how they challenged; how occupational patterns preserve occupational abilities, and how incapability and restrictions as a result of personal, environmental and social hindrances were experienced. In conclusion these studies revealed that very old persons live a creative and varied life and appear to have a variety of management/coping ability for handling the balance between abilities, limitations and environmental demands in everyday life. Daily occupations are mainly performed with the support of assistive devices, though these may be sometimes seen in a negative light. What very old persons experience and how they experience their participation in everyday life greatly affect their self-images, and this is a challenge to everyone who works with elderly persons.