Carin Fredriksson

Elderly persons with disabilities in Sweden: their experiences of everyday life

The aim of this study was to describe the everyday life experiences of 22 elderly persons with physical disabilities in Sweden. The participants were aged between 65 and 91 years. Interviews were conducted and analysed according to a qualitative research approach. Disengagement in activities and social contacts resulted in feelings of resignation and dejection for some participants, while others delegated tasks as a satisfactory alternative. Participants also described how activities and social contacts continued, albeit in a different way, and being active and socializing gave feelings of pleasure and a sense of belonging. While receiving help was experienced as valuable, it also increased the fear of becoming dependent. Occupational therapy intervention should be directed at increasing social contacts and engagements in meaningful activities, as well as strengthening the individuals autonomy. The transferability of the study can be questioned as the sample only included elderly persons with physical disabilities from urban areas. Further research is needed to address the impact of occupational therapy interventions on life satisfaction.

Elderly persons’ expectations of day-care rehabilitation

The aim of this study was to explore elderly persons’ conceptions of what they expected to gain from attending day-care rehabilitation centres (DCR). A purposeful sampling procedure was employed. Interviews with 22 prospective elderly day-care patients were carried out and analysed according to a phenomenographic approach. The analysis yielded eight categories. Two categories, Social contact and Exercise, described what the elderly persons expected to encounter. The remaining categories, A change from the monotony of everyday life, An opportunity to be yourself, A balm for the body, A safety net, A mastery of everyday activities, and An energizing spark, described the meanings of the encounters. Two categories were attributed to the elderly persons’ physical presence at the centre and the gains were expected to end when the programme ended. In three categories the expected improvements were projected into the future and were expected to last. The findings imply that follow-up home visits and suggestions for alternative social activities in order to provide stimulation and social equality would be a valuable complement to the DCR programme. Rehabilitation personnel need to consider the ambivalent view on assistive devices as well as the elderly persons need for continuity when setting goals and planning individual programmes.

Life situation of adults with congenital limb reduction deficiency in Sweden

Abstract Purpose: To describe the current life situation of adults with congenital limb reduction deficiencies (CLRD), living in Sweden, regarding their main daily occupation, leisure activities and self-reported general health. Methods: A cross-sectional survey was conducted using a study-specific questionnaire, sent by post. Hundred and seventeen persons with different extent, forms and levels of CLRD (mean age 33 years) responded to the questionnaire. Results: Work or study was the main occupation for 86% of the participants and 50% had completed a college or university education. About 7% were unemployed and 3% were on sick leave. The participants were highly involved in social and physical activities during leisure time. The majority reported good or very good general health. Conclusion: This study is the first investigation of the life situation of adults with CLRD described with a perspective from Swedish society. The participants were educated and worked to a great extent, which corresponds well to the Swedish population as a whole. Further research is needed, especially with a focus on the internal perspective of life situation, different aspects of work capacity, occurences of strain injuries and the benefit of assistive devices among adults with CLRD. Implications for Rehabilitation People with CLRD require a health care system with a multi-professional rehabilitation team offering regular contact during their life time. Educational system offering study counselling on all education levels (from primary school to university) is an important type of support for people with any kind of deficiency, in order to find suitable education and profession. Work is of importance for an acceptable life situation. Rehabilitation for people with CLRD should emphasise facilitating their ability to work, through engagement in individual personal capacity and self-efficacy. The majority of people with CLRD are users of prostheses and assistive devices. The benefits of the devices are basic but the rehabilitation should also include aspects of usability and use worthiness for individuals in performing their daily activities.

Making Each Other’s Daily Life : Nurse Assistants’ Experiences and Knowledge on Developing a Meaningful Daily Life in Nursing Homes

Background: In a larger action research project, guidelines were generated for how a meaningful daily life could be developed for older persons. In this study, we focused on the nurse assistants’ (NAs) perspectives, as their knowledge is essential for a well-functioning team and quality of care. The aim was to learn from NAs’ experiences and knowledge about how to develop a meaningful daily life for older persons in nursing homes and the meaning NAs ascribe to their work. Methods: The project is based on Participatory and Appreciative Action and Reflection. Data were generated through interviews, participating observations and informal conversations with 27 NAs working in nursing homes in Sweden, and a thematic analysis was used. Result: NAs developed a meaningful daily life by sensing and finding the “right” way of being (Theme 1). They sense and read the older person in order to judge how the person was feeling (Theme 2). They adapt to the older person (Theme 3) and share their daily life (Theme 4). NAs use emotional involvement to develop a meaningful daily life for the older person and meaning in their own work (Theme 5), ultimately making each other’s daily lives meaningful. Conclusion: It was obvious that NAs based the development of a meaningful daily life on different forms of knowledge: the oreticaland practical knowledge, and practical wisdom, all of which are intertwined. These results could be used within the team to constitute a meaningful daily life for older persons in nursing homes.

Older people readmitted to hospital for acute medical care – Implications for occupational therapy

Abstract Objective: To compare ADL, cognitive function, risk of pressure sores, malnutrition and falls in older people readmitted to hospital. Methods: This was a comparative study. Persons ≥ 75 years, who were readmitted to hospital, were assessed using the ADL-taxonomy and the Mini Mental State Examination. Risks of pressure sores, malnutrition and falls were assessed using Risk Assessment Pressure Sores, Short-Form Mini Nutritional Assessment and Downton Fall Risk Index. Data for comparison for ADL were obtained from an earlier study and risk assessments from a national quality register. Results: Sixty persons were included whose median age was 84 years. The patients had a median of four diagnoses. The mean hospital stay was five days. Most patients were independent in food intake. There was a high degree of dependency in other ADL activities. Nineteen out of 48 patients had 24 point or lower in MMSE. Compared to an age-matched sample, these patients showed a higher risk of pressure sores, risk of falls and dependency in ADL. Conclusion: There is of importance to assess ADL, cognition, risk of falls and pressure sores to determine the needs of older people who are admitted to hospitals. Such assessments, and necessary interventions taken, may prevent unnecessary readmissions.