Older rehabilitees’ life-course agency in Finnish gerontological rehabilitation

Abstract

The article contributes to the discussion of how older adults' rehabilitation should be reformed within the Finnish context. The study suggests that a person-centred gerontological rehabilitation process should be conceptualized in terms of an agency-based approach with a personally constructed and temporally embedded life-course perspective. This kind of conceptualizing could promote empowered cooperation and innovative interventions with flexible schedules in the rehabilitation processes of older adults.

Person-Centered Rehabilitation Model: Framing the Concept and Practice of Person-Centered Adult Physical Rehabilitation Based on a Scoping Review and Thematic Analysis of the Literature

“…83 Persons' willingness to participate in rehabilitation decisions need to be monitored, revisited, and accounted for, 30,57,83 not presumed. 84 Finally, PCR implies that professionals' communication is respectful of and tailored to person-specific circumstances. These include persons' cultural values (for a culturally-competent rehabilitation 85,86 ), health literacy, 54,80 educational level, 87 language needs, 88 cognitive or communication impairments, 28,55,[89][90][91][92][93] impaired self-awareness, 94 visual or hearing impairments, 64 or spiritual needs.…”

“…39,138 PCR interactions provide persons with the opportunities and empathetic encouragement for supported self-explorations, as much as the person wants, to addressing issues such as one's life story, situation, life goals, or occupational choices. 23,31,39,47,49,57,72,77,84,99,112,117,118,131,134,138 This helps to frame impairments within a continuum of life changes, link one's past and present to hopes for a meaningful future, and foster the person's capacity to envision relevant life goals and agency-based paths toward their achievement. 21,22,28,39,51,66,69,72,75,77,80,84,92,99,110,116,123,124,127,131 Self-exploration can be supported by narrative, storytelling approaches, 77,85,121,139,140 including exploration of life in retrospect or teleologically 84 or by using tools that identify issues of personal relevance (eg, Canadian Occupational Performance Measure),…”

“…23,31,39,47,49,57,72,77,84,99,112,117,118,131,134,138 This helps to frame impairments within a continuum of life changes, link one's past and present to hopes for a meaningful future, and foster the person's capacity to envision relevant life goals and agency-based paths toward their achievement. 21,22,28,39,51,66,69,72,75,77,80,84,92,99,110,116,123,124,127,131 Self-exploration can be supported by narrative, storytelling approaches, 77,85,121,139,140 including exploration of life in retrospect or teleologically 84 or by using tools that identify issues of personal relevance (eg, Canadian Occupational Performance Measure), 42,67 structured workbooks (eg, for the person to describe "my best day"), 112 metaphorical approaches or imaginary scenarios (eg, on possible 'selves' or alternative outcomes),…”

Ageing, dementia and the future – ambivalent futurework in rehabilitation-focused dementia care

“…Rehabilitation literature has addressed temporality as an issue in rehabilitation, connecting the past and present of the patient with a possible future state ( Mattingly, 1998 ; Papadimitriou & Stone, 2011 ) and revealing a plurality of possible futures ( Mattingly, 1998 ). According to Pikkarainen et al (2015) , who are working in the field of gerontological rehabilitation, a future orientation per se is defining for most rehabilitation practice: rehabilitation being about moving from the present into the future, towards concrete rehabilitation goals. Other recent research on rehabilitation older age supports the idea of rehabilitation as a future-oriented practice.…”

“…The future orientation of rehabilitation practice highlights the need to explore how rehabilitation corresponds with the future orientation of people taking part in rehabilitation. Finding different temporal orientations in a sample of older rehabilitants, Pikkarainen et al (2015) state that in terms of ageing, person-centred rehabilitation should take into consideration the temporal orientation of older adults. And yet, aspects of future orientation have not been explored and discussed within rehabilitation research in the field of dementia.…”