The influence of the environment on participation subsequent to rehabilitation as experienced by elderly people in Norway

Abstract

The aim of this study was to illuminate how the environment may influence participation among elderly people who have undergone community-based rehabilitation in Norway, after an acute illness or accident. Fourteen persons over 65 years of age were selected with the specific intention of gaining a variety of ages, both genders, and people living in different kinds of housing. Three focus groups were established and repeated interviews were held with each group. A constant comparative analysis was used to analyse the data. The main finding was that the participants experienced pressure from their environment to concentrate on performing the most necessary daily activities rather than on participation. Three main encounters with environments seemed to be important for this: encountering people and society, encountering private and formal assistance, and encountering occupation. The support that the participants received from family and friends was more important for their participation than having accessible physical environments. The findings suggest that occupational therapists must consider themselves to be part of a societal environment that can hinder participation.

Utility of the Canadian Occupational Performance Measure as an admission and outcome measure in interdisciplinary community-based geriatric rehabilitation

“…Though the therapists in RCC agree on a service based on values consistent with client-centred practice, they still found it difficult. In particular, being client-centred with some of the elderly citizens was challenging, possibly because they are accustomed to expert knowledge and decisions (3,4,30,41). It is known that one of the hardest skills to obtain using the COPM is the interviewing skills based on the principles of client-centred practice (19,22).…”

“…Conscious inclusion of people in their rehabilitation process enhances meaningfulness and motivation as well as increasing the positive effect of the rehabilitation effort (3,4,9,10). Active involvement in the rehabilitation process reflects ethical standards and democratic values, and meets the legal requirements that guide the activities of municipal government (13)(14)(15)(16).…”

“…Many elderly people are impaired in ways that affect their ability to lead independent and satisfactory lives (1)(2)(3)(4). Concurrently, the complexity of the problems facing the elderly population constitutes a challenge to healthcare personnel and taxes resources, entailing significant cost increases (5)(6)(7).…”

Continuing Mobility and Occupational Participation Outside the Home in Old Age Is an Act of Negotiation

“…Further, there seems to be a tendency among older people to feel obliged to be content and not complain, owing to no longer feeling useful or needed (Vik, Lilja, & Nygård, 2007). In fact, older people seemed to be content if they managed not to be a burden to others, could look back on their life with satisfaction, and experienced other people of the same age as having a more difficult situation (Vik et al, 2007). Feeling obliged to be content might thus be a potential barrier toward mobility and continuing occupational participation.…”

“…Several other articles describe that trips to friends or relatives, that is, activities providing belonging, are the ones first to be omitted if mobility is restricted (Hakamies-Blomqvist, 1999;Oxley et al, 2010;Wretstrand et al, 2009). Further, there seems to be a tendency among older people to feel obliged to be content and not complain, owing to no longer feeling useful or needed (Vik, Lilja, & Nygård, 2007). In fact, older people seemed to be content if they managed not to be a burden to others, could look back on their life with satisfaction, and experienced other people of the same age as having a more difficult situation (Vik et al, 2007).…”