This qualitative study aims to explore the cultural meaning of accomplishing food-related work by older women, when disease has diminished their abilities and threatens to make them dependent. Seventy-two women with stroke, rheumatoid arthritis, and Parkinson's disease, as well as women without those diseases, were interviewed. All were living at home. Results showed that older women valued independence and feared dependence when declining ability threatened performance of food-related work. They also had strong beliefs about living a "normal life," managing by oneself as long as possible, and becoming their own masters again. To remain independent, participants used three kinds of strategies: Public Health Service Support, self-managing, and adaptation. Their beliefs about dependence included not becoming a burden, retaining self-determination, and maintaining order in life. Implications for nursing include supporting independent cooking, developing care plans with the care recipient, and demonstrating respect for the women's self-determination.

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Objectives: To (a) examine participation rate as a function of municipality, age group and living status; and (b) investigate the main reasons for exclusion and declining as stated by the women themselves. Design: Analysis of participation rate and content analysis of statements given in phone calls explaining exclusion or declination from a project in which 24 h recalls and food-diaries were used. Subjects: Self-managing Swedish women (n ¼ 505) were systematically selected from a stratified random sample covering single living and cohabiting women aged 64 -68, 74 -78 and 84 -88 y living in three municipalities. Results: No significant differences were found among included and declining women when municipalities and living status was analysed, but significantly more women in the oldest group were excluded (P > 0.01). Among those in their 80s living at home, the usual reasons for exclusion were illness, disability or dementia, and many lived in institutions for old people. The four most used explanations to decline participation were 'lack of time', 'tired, fragile, sick or having bad memory', 'not willing to participate in scientific studies' and 'too old and nothing to contribute'. Conclusions: The participation rate was, compared with other food surveys in the older generation, fairly good, especially among those in their 80s. However, the most active and the very ill and disabled did not participate.

The main conclusion was that a qualitative method, such as FBCE, must be supplemented with a dietary assessment method giving the energy intake to ensure that it is sufficient, especially when studying groups at risk for malnutrition.