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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
Keywords Aged 80 and over, Activities of daily living (ADL), Decision-making, Grounded theory, Sweden
Subject categories Other Medical Sciences


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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