Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T03:30:43.522Z Has data issue: false hasContentIssue false
  • English
  • Français

Participation in advanced age: enacting values, an adaptive process

Published online by Cambridge University Press:  20 June 2016

PAUL SUGARHOOD ,
PAMELA EAKIN  and
LYNN SUMMERFIELD-MANN
PAUL SUGARHOOD*
Affiliation:
Department of Allied Health Sciences, School of Health and Social Care, London South Bank University, UK.
PAMELA EAKIN
Affiliation:
Department of Allied Health Sciences, School of Health and Social Care, London South Bank University, UK.
LYNN SUMMERFIELD-MANN
Affiliation:
Department of Allied Health Sciences, School of Health and Social Care, London South Bank University, UK.
*
Address for correspondence: Paul Sugarhood, Department of Allied Health Sciences, School of Health and Social Care, London South Bank University, 103 Borough Road, London SE1 0AA, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

The concept of participation, introduced through models such as the International Classification of Functioning, Disability and Health, has become increasingly important in health and social care. However, it has not been consistently defined or operationalised, and there is very limited research into participation in the context of advanced age and disability. This article reports a study which explored participation from the perspectives of community-living people aged over 80 years with physical rehabilitation needs. Using a grounded theory methodology, 11 participants aged 81–96 years were recruited from a National Health Service Trust in the United Kingdom. The main finding was that participation was experienced as the enacting of values. Values provided the motivation for specific ways of participating in life, guided actions and behaviours, and were the means through which participation was interpreted. Commonly enacted values were: connecting with others; maintaining autonomy; affirming abilities; doing the best you can; being useful; maintaining self-identity; and pursuing interests. A process was evident whereby participation was challenged by deteriorating health and losses and the participants adapted (or not) to overcome these challenges. To promote participation in advanced age, health and social care policy and practice must consider the values important to older people. Interventions should be congruent with these values and promote strategies through which they can be enacted.

Keywords

participationInternational Classification of FunctioningDisability and Health (ICF)advanced agedisabilityvalues
Type
Articles
Information
Ageing & Society , Volume 37 , Issue 8 , September 2017 , pp. 1654 - 1680
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Age UK 2013. Improving Later Life: Understanding the Oldest Old. Age UK, London.Google Scholar
Allen, K. and Glasby, J. 2010. Health Service Management Centre Policy Paper. ‘The Billion Dollar Question’: Embedding Prevention in Older People's Services – 10 ‘High Impact’ Changes. Available online at http://www.birmingham.ac.uk/Documents/college-social-sciences/social-policy/HSMC/publications/PolicyPapers/Policy-paper-8.pdf [Accessed 8 March 2015].Google Scholar
Baltes, P. P. 1997. On the incomplete architecture of human ontogeny: selection, optimization, and compensation as foundation of developmental theory. American Psychologist, 52, 4, 366–80.CrossRefGoogle ScholarPubMed
Borell, L., Asaba, E., Rosenberg, L., Schult, M.-L. and Townsend, E. 2006. Exploring experiences of ‘participation’ among individuals living with chronic pain. Scandinavian Journal of Occupational Therapy, 13, 2, 76–85.CrossRefGoogle ScholarPubMed
Cardol, M., de Jong, B. A., Ward, C. D. 2002. On autonomy and participation in rehabilitation. Disability and Rehabilitation, 24, 18, 970–4.CrossRefGoogle ScholarPubMed
Care Services Efficiency Delivery 2009. Benefits of Homecare Re-ablement for People at Different Levels of Need. Care Services Efficiency Delivery/Department of Health, London.Google Scholar
Charmaz, K. 2006. Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Sage, London.Google Scholar
Corbin, J. and Morse, J. M. 2010. The unstructured interactive interview: issues of reciprocity and risks when dealing with sensitive topics. Qualitative Inquiry, 9, 3, 335–54.CrossRefGoogle Scholar
Department of Health 2001. The National Service Framework for Older People. Department of Health, London.Google Scholar
Desrosiers, J. 2005. Participation and occupation. Canadian Journal of Occupational Therapy, 72, 4, 195–203.CrossRefGoogle ScholarPubMed
Desrosiers, J., Robichaud, L., Demers, L. and Gélinas, I. 2009. Comparison and correlates of participation in older adults without disabilities. Archives of Gerontology and Geriatrics, 49, 3, 397–403.CrossRefGoogle ScholarPubMed
Dey, I. 1999. Grounding Grounded Theory. Academic Press, San Diego, California.Google Scholar
Fairhall, N., Sherrington, C., Kurrle, S. E., Lord, S. R. and Cameron, I. D. 2011. ICF participation restriction is common in frail, community-dwelling older people: an observational cross-sectional study. Physiotherapy, 97, 1, 26–32.CrossRefGoogle ScholarPubMed
Finlay, L. 2002. ‘Outing’ the researcher: the provenance, process and practice of reflexivity. Qualitative Health Research, 12, 4, 531–45.CrossRefGoogle ScholarPubMed
Fougeyrollas, P., Noreau, L., Bergeron, H., Cloutier, R., Dion, S. A. and St-Michel, G. 1998. Social consequences of long term impairments and disabilities: conceptual approach and assessment of handicap. International Journal of Rehabilitation Research, 21, 2, 127–41.CrossRefGoogle ScholarPubMed
Glaser, B. G. 1978. Theoretical Sensitivity. The Sociology Press, Mill Valley, California.Google Scholar
Glaser, B. G. 1992. Basics of Grounded Theory Analysis: Emergence Versus Forcing. The Sociology Press, Mill Valley, California.Google Scholar
Glaser, B. G. and Strauss, A. L. 1967. The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine Transaction, New Brunswick, New Jersey.Google Scholar
Great Britain, Parliament 2005. Mental Capacity Act 2005. HMSO, London.Google Scholar
Haak, M., Dahlin Ivanoff, S., Fänge, A., Sixsmith, J. and Iwarsson, I. 2007. Home as the locus and origin for participation: experiences among very old Swedish people. Occupational Therapy Journal of Research: Occupation, Participation and Health, 27, 3, 95–103.CrossRefGoogle Scholar
Häggström, A. and Lund, M. L. 2008. The complexity of participation in daily life: a qualitative study of the experiences of persons with acquired brain injury. Journal of Rehabilitation Medicine, 40, 2, 89–95.CrossRefGoogle ScholarPubMed
Hammel, J., Magasi, S., Heinemann, A., Whiteneck, G., Bogner, J. and Rodriguez, E. 2008. What does participation mean? An insider perspective from people with disabilities. Disability and Rehabilitation, 30, 19, 1445–60.CrossRefGoogle ScholarPubMed
Hemmingsson, H. and Jonsson, H. 2005. An occupational perspective on the concept of participation in the International Classification of Functioning, Disability and Health – some critical remarks. American Journal of Occupational Therapy, 59, 5, 569–76.CrossRefGoogle ScholarPubMed
Kvale, S. and Brinkmann, S. 2009. Interviews: Learning the Craft of Qualitative Research Interviewing. Second edition, Sage, Thousand Oaks, California.Google Scholar
Law, M. 2002. Participation in the occupations of everyday life. American Journal of Occupational Therapy, 56, 6, 640–9.CrossRefGoogle ScholarPubMed
Lincoln, Y. S. and Guba, E. 1985. Naturalistic Inquiry. Sage, Beverley Hills, California.CrossRefGoogle Scholar
Lloyd, L., Calnan, M., Cameron, A., Seymour, J. and Smith, R. 2014. Identity in the fourth age: perseverance, adaptation and maintaining dignity. Ageing & Society. 34, 1, 1–19. doi:10.1017/S0144686X12000761.CrossRefGoogle Scholar
Netherlands Institute for Health Services Research 2007. IPA – The Questionnaire Impact on Participation and Autonomy. Available online at http://www.nivel.nl/en/ipa [Accessed 8 March 2015].Google Scholar
Ostir, G. V., Granger, C. V., Black, T., Roberts, P., Burgos, L., Martinkewiz, P. and Ottenbacher, K. J. 2006. Preliminary results for the PAR-PRO: a measure of home and community participation. Archives of Physical Medicine and Rehabilitation, 87, 8, 1043–51.CrossRefGoogle ScholarPubMed
Patton, M. Q. 2002. Qualitative Research and Evaluation Methods. Third edition, Sage, Thousand Oaks, California.Google Scholar
Rochette, A., Korner-Bitensky, N. and Levasseur, M. 2006. ‘Optimal’ participation: a reflective look. Disability and Rehabilitation, 28, 19, 1231–5.CrossRefGoogle ScholarPubMed
Sayer, A. 2011. Why Things Matter to People: Social Science, Values and Ethical Life. Cambridge University Press, Cambridge.CrossRefGoogle Scholar
Ueda, S. and Okawa, Y. 2003. The subjective dimension of functioning and disability: what is it and what is it for? Disability and Rehabilitation, 25, 11/12, 596–601.CrossRefGoogle ScholarPubMed
van Brakel, W. H., Anderson, A. M., Mutatkar, R. K., Bakirtzief, Z., Nicholls, P. G., Raju, M. S. and Das-Pattanayak, R. K. 2006. The Participation Scale: measuring a key concept in public health. Disability and Rehabilitation, 28, 4, 193–203.CrossRefGoogle ScholarPubMed
Van de Velde, D., Bracke, P., Van Hove, G., Josephsson, S. and Vanderstraeten, G. 2010. Perceived participation, experiences from persons with spinal cord injury in their transition period from hospital to home. International Journal of Rehabilitation Research, 33, 4, 346–55.CrossRefGoogle Scholar
Vasunilashorn, S., Steinman, B. A., Liebig, P. S. and Pynoos, J. 2012. Aging in place: evolution of a research topic whose time has come. Journal of Aging Research, 2012, 120952. doi:10.1155/2012/120952 Google Scholar
Vik, K., Nygård, L., Borell, L. and Josephsson, S. 2008. Agency and engagement: older adults’ experiences of participation in occupation during home-based rehabilitation. Canadian Journal of Occupational Therapy, 75, 5, 262–71.CrossRefGoogle ScholarPubMed
Whiteneck, G. and Dijkers, M. P. 2009. Difficult to measure constructs: conceptual and methodological issues concerning participation and environmental factors. Archives of Physical Medicine and Rehabilitation, 90, supplement 1, S22–35.CrossRefGoogle ScholarPubMed
Wilkie, R., Peat, G., Thomas, E. and Croft, P. 2006. The prevalence of person-perceived participation restriction in community-dwelling older adults. Quality of Life Research, 15, 9, 1471–9.CrossRefGoogle ScholarPubMed
Witsø, A. E., Vik, K. and Ytterhus, B. 2012. Participation in older home care recipients: a value-based process. Activities, Adaptation & Aging, 36, 4, 297–316.Google Scholar
World Health Organization (WHO) 2001. International Classification of Functioning, Disability and Health. WHO, Geneva.Google Scholar
Wright-St Clair, V. 2012. Being occupied with what matters in advanced age. Journal of Occupational Science, 19, 1, 44–53.CrossRefGoogle Scholar