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Older couples' participation in everyday life - when living in changing and shifting contexts
Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.ORCID iD: 0000-0001-5523-104x
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to explore and develop an understanding about older couples’ participation in everyday life when living in shifting contexts. To achieve the aim, multiple perspectives were sought and a variety of qualitative methods were applied. Data were generated through interviews and observations with older couples and through focus groups with spousal caregivers, healthcare professionals, and other stakeholders and those data were analyzed through a constant comparative method, content analysis, and narrative analysis.

From the perspective of spousal caregivers, the findings in study I revealed the complexity and ambiguity that influences participation in everyday life. Being in charge of everyday life was described as challenging in many ways and produced a need for recovery and own time. Interacting with social contexts and being confident with the provided social services, such as respite care, was described as complex. The partner’s wellbeing and participation had an impact on the spousal caregiver’s own participation when living in shifting contexts. The perspective of healthcare professionals related to residential respite care was captured in study II. They described a broad and multifaceted picture of participation in everyday life and how promoting participation for older couples involved building trustworthy relationships, enabling meaningful activities, and arranging a comfortable shared environment. Both of the partners in the older couples needed to be considered by the professionals. In study III, the perspectives of the older couples were explored. In order to understand how meaning and togetherness is created in older couples’ everyday life, the focus has to be on the couples’ whole situation, including their relationship. The results showed that the couples strived to continue living their lives in togetherness. Strategies used by the couples were shifting responsibilities, doing more things together than before, using residential respite care, and rearranging social interactions with family and friends. Study IV offered the perspectives of multiple stakeholders. The findings suggested that the focus has to be on older couples through maintaining abilities and creating comfort. Support is also required from both an engaged civil society and healthcare professionals that are motivated and have both competence and time. Further, social services need to work together to ensure that resources are properly available.

Overall, this thesis contributes to a deeper understanding about older couples’ participation in everyday life when living in shifting contexts. The findings showed that acknowledging the couples’ relationship, seeing beyond the client and the spousal caregiver, was vital for supporting their participation. Furthermore, living in shifting contexts was multifaceted and the couples strived to continue living their lives in togetherness. The meaning that the change of life situation and context has on a couple’s participation in everyday life is important to consider when supporting aging in place. In light of demographic changes and challenges, bringing together the interests of older couples, professionals, systems of services, and civil society is vital for a sustainable future. Systems and situations that are both closely and remotely related to the older couples’ daily life need to be addressed in an ideal situation of aging in place. Knowledge from this thesis could be valuable for occupational therapists and other healthcare professionals, as well as social services that are supporting older couples to age in place. Consequently, this knowledge could be used to benefit the situations of older couples and their health and wellbeing when aging in place.

Place, publisher, year, edition, pages
Luleå: Luleå University of Technology, 2019.
Series
Doctoral thesis / Luleå University of Technology, ISSN 1402-1544
Keywords [en]
aging in place, older adults, older couples, occupational therapy, participation, respite care, shifting contexts, togetherness, qualitative methodology
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
URN: urn:nbn:se:ltu:diva-73420ISBN: 978-91-7790-358-1 (print)ISBN: 978-91-7790-359-8 (electronic)OAI: oai:DiVA.org:ltu-73420DiVA, id: diva2:1305314
Public defence
2019-06-18, E632, Luleå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2019-04-16 Created: 2019-04-16 Last updated: 2025-10-22Bibliographically approved
List of papers
1. Healthcare professionals’ perspective on how to promote older couples’ participation in everyday life when using respite care
Open this publication in new window or tab >>Healthcare professionals’ perspective on how to promote older couples’ participation in everyday life when using respite care
2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 2, p. 427-435Article in journal (Refereed) Published
Abstract [en]

Aims

The aim is to describe healthcare professionals’ perspectives on how they understand and promote older couples’ participation in everyday life when using residential respite care.

Design and Methods

Eighteen healthcare professionals with varying degrees of competence and from one residential respite care facility participated in four focus group interviews. Data were analysed through qualitative latent content analysis.

Findings

The findings revealed a broad, multifaceted view of participation and ways in which participation in everyday life is promoted by these professionals. Trustworthy relationships between professionals, spousal caregivers and clients were implicated. Promoting participation also necessitated that clients have access to meaningful activities. In addition, participation entailed an environment that supported various needs.

Conclusion

Promoting participation for older couples that are using respite care involves multifaceted perspectives that consider social–relational aspects including both the client and their spouse. Furthermore, attention is needed to the meaning a change of context between home and the respite care facility has on relationships, environments and activities in everyday life. Such an approach could benefit the couples’ shared everyday life situation and in a wider perspective, also influence their health and well‐being when ageing in place together.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
caregivers, elder care, focus groups, older adults, participation, qualitative approaches, respite service
National Category
Occupational Therapy Physiotherapy
Research subject
Occupational therapy; Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-72673 (URN)10.1111/scs.12640 (DOI)000472973400018 ()30570154 (PubMedID)2-s2.0-85058954992 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-07-10 (johcin)

Available from: 2019-01-24 Created: 2019-01-24 Last updated: 2025-10-22Bibliographically approved
2. Strategies of older couples to sustain togetherness
Open this publication in new window or tab >>Strategies of older couples to sustain togetherness
2019 (English)In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 48, p. 60-66Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore how elderly couples, who are in need of social services in the community, act and reason over time regarding their everyday togetherness. Data were generated through repeated interviews and participant observations with three older couples. A narrative method was used for data generation and analysis. The findings present four parallel narratives illustrating how the couples, over time, strove to continue living their lives in togetherness despite the many challenges that had emerged. These narratives show the complexity and variety of strategies that the couples adopted to handle different situations of everyday life and the couples’ experiences and feelings connected to these situations. The strategies that the couples used resulted, for example, in performing more activities together in another way, using respite care and reorganizing their social interactions. The spousal caregiver had a leading role to manage day-to-day life and to initiate and perform the strategies. Simultaneously, an important reciprocity existed in their relationship that gave meaning to their efforts of sustaining togetherness. These findings give a deeper understanding of the complexity of their situation and of how meaning is created in their everyday life through enacted togetherness. The findings highlight the need for professionals within social services in the community to embrace a couple's whole situation, involving both partners. 

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Narrative, Older adults, Participation, Relationships, Respite care, Togetherness
National Category
Occupational Therapy Physiotherapy
Research subject
Occupational therapy; Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-72772 (URN)10.1016/j.jaging.2019.01.005 (DOI)000462421500008 ()30832931 (PubMedID)2-s2.0-85060436837 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-02-06 (svasva)

Available from: 2019-02-06 Created: 2019-02-06 Last updated: 2025-10-22Bibliographically approved
3. Spousal caregivers’ experiences of participation in everyday life when living in shifting contexts
Open this publication in new window or tab >>Spousal caregivers’ experiences of participation in everyday life when living in shifting contexts
2018 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, no 6, p. 457-465Article in journal (Refereed) Published
Abstract [en]

Background: To promote health and well-being, and to meet the desires of the growing elderly population to age in place, elderly spousal caregivers need adequate support such as respite care services. More knowledge is needed about elderly spousal caregivers’ experiences in relation to participation, which is an aspect of health that remains relatively unexplored for this group.

Aim: To explore and describe how elderly spousal caregivers experience and discuss participation in everyday life when living in shifting contexts due to the use of respite care.

Method: A grounded theory approach was used during data generation and analysis, which involved repeated focus group interviews with 12 spousal caregivers.

Results: Complexity and ambiguity was understood to imbue participation in everyday life. Being in charge of everyday life was challenging for spousal caregivers, and created a need for personal time. Respite care and home care service gave them time, although when interacting with social contexts other issues arose that influenced their own recovery.

Conclusions: A holistic ‘situation centered’ approach that focuses on the elderly couple’s life story and needs might capture a wider perspective and enable adequate support that influences their health, well-being, and participation in everyday life.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Aged, grounded theory, health, occupational therapy, rehabilitation, respite care
National Category
Occupational Therapy Physiotherapy
Research subject
Occupational Therapy; Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-63988 (URN)10.1080/11038128.2017.1337810 (DOI)000458235400006 ()28602117 (PubMedID)2-s2.0-85020672590 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-03-11 (johcin)

Available from: 2017-06-14 Created: 2017-06-14 Last updated: 2025-10-22Bibliographically approved

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