The experience of older people of entering into the phase of asking for public home help – a qualitative study

Abstract

The aim of this qualitative study was to explore older persons’ (n = 28, 75–96 years of age) experience of becoming in need of public home help, their experience of participation and of having influence on the needs assessment procedure and the decisions made about public home help. A content analysis revealed a broad overarching category, labelled: experiencing discontinuity in life as a whole – the countdown has begun. In addition, four principal categories emerged from the data: comparing the past with the present and losing parts of oneself and connectedness; worrying about the losses and what they will bring about; struggling against losing abilities to avoid dependency and home help; and struggling with conflicting feelings about being/becoming in need of help, and from whom. That older people can so perceive their life situation needs to be recognised if they are to be empowered to become involved in and exert influence on the assessment process and its outcome as well as on their life situation as a whole.

Older People's “Voices”—On Paper: Obstacles to Influence in Welfare States—A Case Study of Sweden

“…Still, 60% of the municipalities lacked a policy for feedback on complaints. Even if the complaint cannot be resolved immediately, earlier studies have emphasized the importance of establishing efficient ways to deal with incoming complaints (Janlöv, Hallberg, & Petersson, 2005). Whereas exit can be a relatively fast and efficient way to show dissatisfaction, the use of complaint forms as a formal voice channel may take anywhere from a day to several weeks.…”

‘You don't show everyone your weakness’: Older adults' views on using Family Group Conferencing to regain control and autonomy

“…Contrastingly, step by step accepting and perhaps even asking for support, slowly letting it happen, seems to be easier to cope with, perhaps because it also slows down the process of losing control. Research by Janlöv et al (2005) points out that older adults experience the acceptance of formal care as a new phase in life, in which the end is near. This might also be the case with informal care, which might further explain older adults' negative emotions concerning FGC.…”

“…According to Becker (1994) people will not look at themselves as old, frail or dependent as long as they are still healthy. Furthermore, being old is often related to being dependent on (formal) care, which according to Janlöv et al (2005) causes older adults to fear that they are losing parts of themselves and their connection with others or even the world. This might instigate the tendency to postpone asking for help until it can no longer be avoided.…”

Home-care clients’ need for help, and use and costs of services

“…It is already known that the consequences of comorbidity, pain and low functional ability are often helplessness and dependency, which can contribute to a higher frequency of anxiety, feelings of insecurity and mental disorders (Grimmer et al 2004;Kvaal and Laake 2003;Ellefsen 2002;Hellsröm and Hallberg 2001;Kvaal et al 2001;Rannhoff 1997). Janlöv et al (2005) underline that when older people face the fact that they need help, it evokes anxiety as it means a new, unknown and potentially unpleasant situation (see also Pot et al 2005). In Rannhoff and Laake's study (1995), home help clients suffered from poor physical as well as psychosocial health (sleeping problems, loneliness).…”