‘Holding on to life’: An ethnographic study of living well at home in old age

Abstract

In recent years, much attention has been paid to how older people living at home can remain independent and manage their illness themselves, while less attention has been given to those who have become frail and need assistance with challenges of everyday life. In this article, I drew on Latimer's formulation of care for frail older people as relational and world-making and on Foucault's work related to the care of the self in developing an understanding of how frail older persons manage to live well at home in the final years of their lives. I use data from an ethnographic study of home care nursing in the homes of 15 frail older people to develop an understanding of how their care at home can be developed. The participants were holding on to life, which reflected their vitality and vulnerability as well as agency in continuing to explore ways to preserve and build their world at home. With declining ability and stamina relations with material things, relatives and official care workers become of central importance in holding on to life. Home care services can be thought of as part of life, as world-forming, where workers contribute to daily activities that support living well at home.

Acceptance and adjustment: A qualitative study of experiences of hearing and vision impairments and daily life among oldest old recipients of home care

“…Reduced vision was annoying when it made reading the newspaper difficult or when they had to ask for help with changing light bulbs or other simple practical everyday tasks. Such findings concur with previous reports on how hearing and vision impairments affect everyday competencies (Tiwana, Benbow, & Kingston, ; Bjørnsdottir, ). Hearing impairment in particular is a burden in social life, while vision impairment strongly impacts everyday competencies (Heyl & Wahl, ).…”

“Fiercely independent”: Experiences of aging in the right place of older women living alone with physical limitations

“…They also actively provided it to others. This finding overlaps with the concepts of “vitality and agency in frailty” for preserving self-identity and continued self-development in later life ( Bjornsdottir, 2018 ; Latimer, 2012 ). It also highlights the crucial role of opportunities for social participation, meaningful and reciprocal contribution, and relationship building to aging in place.…”

What matters to people aged 80 and over regarding ambulatory care? A systematic review and meta-synthesis of qualitative studies

“…This theme represents the external perception and selfperception of aged persons within care relationships. While most of these people had to deal with physical and mental deteriorations such as diminished vision and, consequently, restrictions such as loss of mobility, they focused on the remaining options available to them-they wanted to enjoy their lives despite their old age (Behm et al 2013;Bjornsdottir 2018;Faeo et al 2020;Moe et al 2013;Spoorenberg et al 2015). The primary studies showed that older people wanted to be seen and accepted as valuable individuals who still act on their own, take pleasure in daily activities and contribute something to society (Behm et al 2013;Krothe 1992;Martin-Matthews and Sims-Gould 2008;Moe et al 2013;Tiilikainen et al 2019;Toien et al 2015).…”

“…More explicitly, experiencing friendliness and respect made older people feel valuable, while experiencing rudeness and disrespect made them feel burdensome and unimportant (Bjornsdottir 2018;Jarling et al 2018;Moe et al 2013;Soodeen et al 2007;Toien et al 2015). Such negative care relationship experiences inhibited open communication between the older persons and their healthcare providers (Jarling et al 2018;Moe et al 2013).…”

“…This related to several aspects of their healthcare structures and care relationships. It became apparent that participants adapted to age-related changes on their own, for instance by giving up certain activities, and that they tried to manage as many things as they could on their own (Behm et al 2013;Bjornsdottir 2018;Krothe 1992;Michel et al 2015;Modig et al 2012;Sandberg et al 2014;Soodeen et al 2007). A participant in Soodeen et al (2007) explained: You've got more self-worth, you know, thinking, 'well, I can do it for myself yet' (p. 1247, home care).…”