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Shifting between self-governing and being governed: a qualitative study of older persons’ self-determination

Journal article
Authors Isabelle Ottenvall Hammar
Synneve Dahlin-Ivanoff
Katarina Wilhelmson
Kajsa Eklund
Published in BMC Geriatrics
Volume 14
ISSN 1471-2318
Publication year 2014
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Centre for Ageing and Health (Agecap)
Language en
Links dx.doi.org/10.1186/1471-2318-14-126
Keywords Aged 80 and over, Activities of daily living (ADL), Decision-making, Grounded theory, Sweden
Subject categories Other Medical Sciences

Abstract

Background: Older persons’ right to exercise self-determination in daily life is supported by several laws. Research shows that older persons’ self-determination is not fully respected within the healthcare sector. In order to enable and enhance older persons’ self-determination, extensive knowledge of older persons’ self-determination is needed. Aim: To explore experiences of self-determination when developing dependence in daily activities among community-dwelling persons 80 years and older. Methods: Qualitative interviews were performed in accordance with a grounded theory method, with 11 persons aged 84–95 years who were beginning to develop dependence in daily activities. Results: The data analysis revealed the core category, “Self-determination - shifting between self-governing and being governed”. The core category comprised three categories: “Struggling against the aging body”, “Decision-making is relational”, and “Guarding one’s own independence”. Self-determination in daily activities was related to a shifting, which was two-fold, and varied between self-governing and being governed by the aging body, or by others. Conclusions: The findings imply a need to adopt a person-centered approach where the older persons’ own preferences and needs are in focus, in order to enhance their possibilities to exercise self-determination.

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