Older people’s dependence on caregivers’ help in their own homes and their lived experiences of their opportunity to make independent decisions

Breitholtz, Agneta; Snellman, Ingrid; Fagerberg, Ingegerd

doi:10.1111/j.1748-3743.2012.00338.x

Cited by 48 publications

(103 citation statements)

References 36 publications

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“…Health care professionals have to provide adjusted information, based on concrete disorders, treatments, sex, ethnicity, and prognosis 31. Elderly patients may also need time to describe their everyday lives, to identify factors motivating the patient towards a change of lifestyle,42 and, if caregivers are in a hurry, they might not see seniors as individuals 43…”

Section: Discussionmentioning

confidence: 99%

Mental health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity

Grundberg¹,

Ebbeskog

Gustafsson

et al. 2014

JMDH

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Mental health promotion needs to be studied more deeply within the context of primary care, because persons with multiple chronic conditions are at risk of developing poor mental health. In order to make progress in the understanding of mental health promotion, the aim of this study was to describe the experiences of health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity – what these seniors believe is important for achieving a dialogue that may promote their mental health. Seven interviews with six women and one man, aged 83–96 years, were analyzed using qualitative content analysis. The results were summarized into nine subcategories and three categories. The underlying meaning of the text was formulated into an overarching theme that embraced every category, “perceived and well-managed as a unique individual”. These seniors with multimorbidity missed someone to talk to about their mental health, and needed partners that were accessible for health dialogues that could promote mental health. The participants missed friends and relatives to talk to and they (crucially) lacked health care or social service providers for health-promoting dialogues that may promote mental health. An optimal level of care can be achieved through involvement, continuity, and by providing a health-promoting dialogue based on seniors’ needs and wishes, with the remembrance that general health promotion also may promote mental health. Implications for clinical practice and further research are discussed.

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Section: Discussionmentioning

confidence: 99%

Mental health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity

Grundberg¹,

Ebbeskog

Gustafsson

et al. 2014

JMDH

View full text Add to dashboard Cite

show abstract

“…The participants were seven older persons who had been part of the project from the start and who are presented elsewhere [15]. The inclusion criteria were aged 70 or more, both men and women, being able to speak and understand Swedish, and varied levels of care needs and still living alone at home with daily help from municipal home help services.…”

Section: Methodsmentioning

confidence: 99%

“…The interviews were conducted during and after one of the participating older persons' professional carer, they were paired with, participated in an educational programme. The same [15] open-ended interview guide was used with open questions such as the following. Can you tell me what it is like when professional carers help you with your daily care?…”

Section: Methodsmentioning

confidence: 99%

“…Nevertheless research shows the complexity of the balance between independence and dependence for older people in home help care. In addition the findings in Breitholtz et al [15] study reveal that the older persons struggled for the opportunity versus resigning themselves to losing the opportunity to make their own decisions. This was further understood as the older persons are not being treated as individuals, not having their needs met, and their life situation being stressful.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Living with Uncertainty: Older Persons’ Lived Experience of Making Independent Decisions over Time

Breitholtz

Snellman

Fagerberg

2013

Nursing Research and Practice

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The aim of the study was to illuminate the meaning of older persons' independent decision making concerning their daily care. Autonomy when in care is highly valued in the western world. However, research shows that autonomy can give rise to problematic issues. The complexity of independence and dependence for older people when living at home with help has also been highlighted. In Sweden, older people are increasingly expected to live at home with help from municipal home care services, and study into this aspect of care is limited. This study is a part of an ongoing project and has a qualitative life world perspective. Audiotaped narrative interviews were conducted and analysed using a phenomenological hermeneutic method. Findings revealed a main theme: “living with uncertainty as to how to relate one's own independence and dependence with regard to oneself, and others.” This involves a constant process of relating to one's independence controlled by others or oneself, and adjusting one's independence and dependence with regard to oneself and others. The conclusion is that professional carers need to acknowledge the changing vulnerability of dependent older persons over time. The implication is a relational approach to autonomy beyond the traditional individualistic approach.

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“…However, the value of freedom of choice and autonomy in the life of older people is not uniformly understood among older people and their carers [9]. Anyone working with older people should be aware of heterogeneous preferences and needs among individuals and respect these differences in their work as a way to truly advance freedom of choice [1213]. …”

Section: Freedom Of Choice In Care Servicesmentioning

confidence: 99%

The Association between Freedom of Choice and Effectiveness of Home Care Services

Steffansson

Pulliainen

Kettunen

et al. 2016

International Journal of Integrated Care

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Objectives: The aim of this paper is to study home care clients’ freedom to choose their services, as well the association between the effectiveness of home care services and freedom of choice, among other factors.Methods: A structured postal survey was conducted among regular home care clients (n = 2096) aged 65 or older in three towns in Finland. Freedom of choice was studied based on clients’ subjective experiences. The effectiveness of the services was evaluated by means of changes in the social-care-related quality of life. Regression analyses were used to test associations.Results: As much as 62% of home care recipients reported having some choice regarding their services. Choosing meals and visiting times for the care worker were associated with better effectiveness. The basic model, which included needs and other factors expected to have an impact on quality of life, explained 15.4% of the changes in quality of life, while the extended model, which included the freedom-of-choice variables, explained 17.4%. The inclusion of freedom-of-choice variables increased the adjusted coefficient of determination by 2%. There was a significant positive association between freedom of choice and the effectiveness of public home care services.Conclusion: Freedom of choice does not exist for all clients of home care who desire it. By changing social welfare activities and structures, it is possible to show respect for clients’ opinions and to thereby improve the effectiveness of home care services.

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Older people’s dependence on caregivers’ help in their own homes and their lived experiences of their opportunity to make independent decisions

Cited by 48 publications

References 36 publications

Mental health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity

Mental health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity

Living with Uncertainty: Older Persons’ Lived Experience of Making Independent Decisions over Time

The Association between Freedom of Choice and Effectiveness of Home Care Services

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