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Self-determination among frail older persons – a desirable goal older persons’ conceptions of self-determination

Christina Ekelund (PhD Student, Reg. Occupational Therapist, based at Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg and Vårdalinstitutet – The Swedish Institute for Health Sciences, Gothenburg, Sweden)
Lena Mårtensson (PhD, Lecturer in Occupational Therapy, based at Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden)
Kajsa Eklund (Associate Professor in Occupational Therapy, Program Director of the OT Program Gothenburg University, based at Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg and Vårdalinstitutet – The Swedish Institute for Health Sciences, Gothenburg, Sweden)

Quality in Ageing and Older Adults

ISSN: 1471-7794

Article publication date: 3 June 2014

501

Abstract

Purpose

Self-determination is governed by ethical and legal rights in western society. In spite of that, older people are still restricted by others in their decision-making processes. The purpose of this paper is to explore older persons’ different conceptions of self-determination.

Design/methodology/approach

A qualitative phenomenographic interview study on frail older persons (n=15).

Findings

Three categories emerged, showing the variations of conception of self-determination as experienced by frail older people: first, self-determination changes throughout life; second, self-determination is being an agent in one's own life; and third, self-determination is conditional. In summary, while self-determination is changeable throughout life, and older persons want to be their own agents, and struggle to be that, certain conditions must be met to make it possible for them to be able to exercise self-determination.

Practical implications

Suggestions for supporting and strengthening frail older persons’ self-determination, and indirectly their well-being and health: to have a person-centered approach, treat them with dignity and respect and give them opportunities to influence and to feel involved; to improve their health literacy by, for example, supporting them with enough knowledge to be able to exercise self-determination; to make them feel safe and secure in relationships, such as with family and caregivers.

Originality/value

This study explores frail older persons’ own conceptions of self-determination to be able to gain knowledge of how professionals can support them so that they may experience self-determination in life.

Keywords

Acknowledgements

Vårdalinstitutet – The Swedish Institute for Health Science, Gothenburg, Sweden (www.vardalinstitutet.net) and Vinnvård, Stockholm, Sweden (www.vinnvard.se). The result of the paper has been presented orally at AT – FORUM (Swedish National Conference for Occupational Therapists), held in Stockholm April 24-25, 2013.

Citation

Ekelund, C., Mårtensson, L. and Eklund, K. (2014), "Self-determination among frail older persons – a desirable goal older persons’ conceptions of self-determination", Quality in Ageing and Older Adults, Vol. 15 No. 2, pp. 90-101. https://doi.org/10.1108/QAOA-06-2013-0015

Publisher

:

Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited

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