Valerie Wright-St Clair

Life and Living in Advanced Age: A Cohort Study in New Zealand -Te Puāwaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ: Study protocol

BackgroundThe number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous Māori, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for Māori and non-Māori in New Zealand.Methods/designA total population cohort study of those of advanced age. Two cohorts of equal size, Māori aged 80–90 and non-Māori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (Māori tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures - a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for Māori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing and vision, anthropometric measures, respiratory function testing and blood samples.DiscussionA longitudinal study of people of advanced age is underway in New Zealand. The health status of a population based sample of older people will be established and predictors of successful ageing determined.

Offerings: Food Traditions of Older Thai Women at Songkran

Abstract “It is deep within our hearts that we have to do this.” Such words reflect the potency of subjective and social meaning of food occupations for older Thai women at Songkran, the traditional Thai New Year. This paper presents the Thai findings from a multi‐site research project exploring older womens experiences of food occupations at Songkran in Chiang Mai, Thailand; and Christmas in Auckland, New Zealand, and Kentucky, USA. Narrative data for this study were collected through focus group interviews with 33 Thai women aged 60 years or over as the women talked about planning, preparing, and offering food at Songkran. The womens stories reveal the centrality of carrying on ritualistic food traditions in Chiang Mai society. They must know and follow the ancient ways and recipes taught by mothers and grandmothers as they prepare themselves and the foods for going to the temple where they offer food to the monks and their deceased ancestors. Happiness comes from earning merit, doing the jobs themselves and knowing they contribute to a good and generous Thai society. Their ways are the traditional ways. Doing and passing on food occupations to their daughters and granddaughters will “serve the good traditions forever.” The findings from this study contribute to the occupational science literature through documenting food occupations and their meanings for older women within one cultural group. The multi‐site nature of the project contributes to understandings of occupation that transcend cultural boundaries.

Being Occupied with What Matters in Advanced Age

This article illuminates one key finding of an interpretive phenomenological study that brought an occupational lens to exploring how elders experience being aged in their everyday lives. Fifteen community-dwelling, New Zealand elders aged 71 to 97, 4 Māori and 11 non-Māori, were purposively recruited. Data were gathered through individual interviews focused on stories of everyday moments and photographs of the participants hands while engaged in a chosen occupation. Discrete stories were drawn from the narrative data and interpreted, guided by Gadamerian hermeneutics and Heideggerian phenomenology. The notion of ‘doing what matters’ emerged as participants spoke of having one occupation that was of primary importance to them. This one compelling pursuit showed as an enduring interest over time, illuminating the temporal unity of past, present and future in advanced age. Accordingly, the boundaries of researching occupational engagement in advanced age ought to be redefined. Instead of a current emphasis on understanding elders’ participation in daily activities, activity categories and patterns, occupational science research might deepen the focus to understand how engagement in subjectively compelling occupations is associated with ageing well and longevity.This article illuminates one key finding of an interpretive phenomenological study that brought an occupational lens to exploring how elders experience being aged in their everyday lives. Fifteen community-dwelling, New Zealand elders aged 71 to 97, 4 Māori and 11 non-Māori, were purposively recruited. Data were gathered through individual interviews focused on stories of everyday moments and photographs of the participants hands while engaged in a chosen occupation. Discrete stories were drawn from the narrative data and interpreted, guided by Gadamerian hermeneutics and Heideggerian phenomenology. The notion of ‘doing what matters’ emerged as participants spoke of having one occupation that was of primary importance to them. This one compelling pursuit showed as an enduring interest over time, illuminating the temporal unity of past, present and future in advanced age. Accordingly, the boundaries of researching occupational engagement in advanced age ought to be redefined. Instead of a current emphasis...

History in the Making: Older Canadian Women’s Food-Related Practices

Many societies have traditionally considered cooking nourishing food for the family to be a natural occupation of women. This article outlines the findings of a small-scale, interpretive study focusing on older Canadian womens participation in planning, preparing, serving, and sharing food for Christmas. The 20 participants, who each took part in one of three focus group discussions, ranged in age from 65 to 93. They were recruited through the Womens Institute in Alberta, Canada and all were from a rural background. Analysis revealed that the meanings of preparing food for family and others at Christmas are shaped by personal, social, cultural, historical, and religious influences. The findings open lines of inquiry into ways these and the next generation of women support the continuation of traditional practices and resist and adjust to change.

Storymaking and Storytelling: Making Sense of Living with Multiple Sclerosis

Abstract This paper presents one interpretive element of a qualitative study aimed at understanding the lived experience of women with multiple sclerosis. Data were gathered from 16 women by way of a focus group interview (six women) and ten semi‐structured individual interviews. Symbolic interactionism was used to build a theoretical foundation for interpreting the day‐to‐day dynamic relationship between the person, the symbolic meaning of their illness, and their occupations. Narrative quotes have been used in the text to illustrate how the raw data informed the interpretive process. People often use metaphors when it is hard to depict the subjective meaning of things in everyday words. As women in this study talked about living with multiple sclerosis, they crafted narrative images richly embroidered with metaphor. The womens engagement in the intuitive occupations of storymaking and storytelling reveals a rich use of analogies and metaphors to make meaning of and to develop occupational strategies for managing the intrusiveness of their illness in their everyday lived world.

The lived experience of physically active older prostate cancer survivors on androgen deprivation therapy

Abstract This study sought to explore the lived experiences of physically active prostate cancer survivors on androgen deprivation therapy (ADT), who exercise individually. Three older men (74–88 years old) with prostate cancer, using ADT continuously for at least 12 months and regularly exercising for at least 6 months, participated in this qualitative pilot study, informed by interpretive phenomenology. Data were gathered using individual semi-structured interviews, audio recorded and transcribed verbatim. Coherent stories were drawn from each transcript and analyzed using iterative and interpretive methods. van Manen’s lifeworld existentials provided a framework for interpreting across the research text. Three notions emerged: Getting started, Having a routine and Being with music. Together they reveal what drew the participants to exercising regularly despite the challenges associated with their cancer and treatments. This study provides insights into the benefits of, and what it means for, older men with prostate cancer to regularly exercise individually. These findings may assist cancer clinicians and other allied health professionals to be more attuned to prostate cancer survivors’ lived experiences when undergoing ADT, allowing clinicians to better promote regular exercise to their patients as a foundational component of living well.

Older Asian immigrants’ participation as cultural enfranchisement

ABSTRACT Research evidence suggests that older immigrants’ resettlement in a new host country is hindered by limited opportunities to engage within communities in deeply familiar ways, using culturally meaningful occupations. A recent study concluded that older Asian immigrants contribute to social capital; yet there is little understanding of how they go about doing so. This New Zealand study examined how older Chinese, Indian, and Korean immigrants’ participation contributes to civic society. Research partnerships were established with bilingual local intermediaries, who assisted the study’s design and implementation. Bilingual research assistants and translators were contracted to assist with recruitment, data gathering, and transcript translation. Recruitment was conducted through venues where older immigrant ethnic groups frequented. The 74 participants were Chinese (24), Indian (25), and Korean (25) immigrants, aged 60 to 83 years, who were aged 55 or older on arrival, and had resided in New Zealand between 1 and 19 years. Nine focus group interviews, three with each ethnic group, were conducted and analysed. Subsequently, 15 participants, five from each ethnic group, were theoretically sampled for individual interview. Three culture-specific provisional theories were developed. Similarities in the theoretical dimensions justified the analytic development of one cross-cultural theory. The resulting theory showed how their engagement with, and participation in, socially embedded older immigrant networks become a form of cultural enfranchisement and a pathway towards wider civic participation. While still largely hidden from societal view, these older immigrants found ways of giving service and strengthening community for the good of all.

Cross-cultural understandings of festival food-related activities for older women in Chiang Mai, Thailand, Eastern Kentucky, USA and Auckland, New Zealand.

This cross-country, cross-cultural study explored the meaning of older women’s food-related activities for the annual festivals of Songkran (Thai New Year) in Chiang Mai, Thailand; and Christmas in Richmond, Kentucky, USA; and Auckland, New Zealand. A derived etic method was used. The community-dwelling participants were 33 Thai women, aged 60 and older, and 16 New Zealand and 23 eastern Kentucky women, aged 65 and older. This article focuses on the final cross-cultural analysis of the data. Emic, or within-country, findings are presented, followed by the derived etic, or cross-cultural, interpretations for two themes of meaning; older women’s ‘protecting what matters’ and ‘leading the way’. Applying derived etic methods helped reveal how, despite the highly different food-related practices, preparing and sharing celebratory foods at Songkran or Christmas held related meanings for older women in Thailand, Kentucky USA, and New Zealand.

Integrative review of older adult loneliness and social isolation in Aotearoa/New Zealand

To conduct an integrative review of empirical studies of loneliness for older people in Aotearoa/New Zealand. Loneliness is a risk factor for older peoples poor physical and cognitive health, serious illness and mortality. A national survey showed loneliness rates vary by gender and ethnicity.

Doing what's important: Valued activities for older New Zealand Māori and non-Māori

Aim:  This project explored the usability of the World Health Organisation, International Classification of Functioning, Disability and Health (ICF) for describing older Māori and non‐Māori peoples self‐nominated important activities.