Seniors’ self-preservation by maintaining established self and defying deterioration – A grounded theory

Abstract

The purpose of this classic grounded theory study was to understand how seniors who are living independently resolve issues influenced by visual impairment and high fall risk. We interviewed and observed 13 seniors with visual impairment in their homes. We also interviewed six visual instructors with experience from many hundreds of relevant incidents from the same group of seniors. We found that the seniors are resolving their main concern of “remaining themselves as who they used to be” by self-preservation. Within this category, the strategies maintaining the established self and defying deterioration emerged as the most prominent in our data. The theme maintaining the established self is mostly guided by change inertia and includes living the past (retaining past activities, reminiscing, and keeping the home intact) and facading (hiding impairment, leading to avoidance of becoming a burden and to risk juggling). Defying deterioration is a proactive scheme and involves moving (by exercising, adapting activities, using walking aids, driving), adapting (by finding new ways), and networking by sustaining old support networks or finding new networks. Self-preservation is generic human behavior and modifying this theory to other fields may therefore be worthwhile. In addition, health care providers may have use for the theory in fall preventive planning.

Perpetuating ability to live life as usual: a grounded theory study of persons living with age-related macular degeneration

“…Despite difficulties, the participants in our study persevered and continued to participate in activities at home and places outside their homes, even if they were dependent on others by trusting their own ability . This is essential, because continuing with activities and social relationships strengthens older adults’ self-confidence and independence despite the obstacles caused by visual impairment [ 32 , 33 ]. Based on the older adults’ beliefs society can set up meeting arrangements, such as making it easier for older people to participate in organised activities.…”

‘Maintaining balance in life’—exploring older adults’ long-term engagement in self-managed digital fall prevention exercise

“…The starting point for the older adults’ exercise habits in our study was the experienced need to act against a threat of loss of physical function, which was seen as a prerequisite for independence. The strong driving force to remain autonomous has also been seen in a qualitative study of fall risk perceptions among visually impaired persons, for which the desire for independence was found to be closely linked to a wish to remain the same person they used to be despite ageing [ 24 ]. In contrast to our study, this wish can lead to setting up a façade, both to oneself and others, ignoring [ 25 ] or rejecting [ 26 ] the need for fall prevention measures.…”

“…In the past, physical activity and exercise behaviour has been explained by intention, such as in the theory of planned behaviour [ 29 ]. However, the intention-behaviour gap has been shown to be hard to overcome when engaging in fall prevention interventions because of changes in inertia [ 24 ], or perceived barriers, i.e., practical issues such as transportation, concerns about exercise, or lack of support or interest [ 30 ]. Self-regulatory strategies such as goal setting and action planning can be ways to bridge the intention-behaviour gap for physical activity among older adults [ 31 , 32 ].…”

Upside Down Hospital: Co-Producing Safety With Patients

“…Assumptions: We base our work on the assumption that self-preservation is a key human characteristic that can drive the behaviour of individuals (Eriksson, Hildingh, Buer, & Thulesius, 2016) and their relatives (Egerod & Overgaard, 2012) and that this is a driver that is unique to patients. Our second assumption, is that patients and their carers already participate heavily in their own healthcare not on their own but as part of the broader healthcare team.…”