Supporting the mobilization of health assets among older community dwellers residing in senior-only households in Singapore: a qualitative study

Abstract

Background Care activities provided by community health practitioners for older adults primarily focused on disease prevention and management. However, healthy longevity can go beyond disease prevention and management and promote greater well-being by tapping into the accrual of resources that older adults possess using the salutogenic approach. This study explored how health resources are used among older adults who are residing in senior-only households to promote and maintain health, with the intent of providing insights into how community health practitioners can support these older adults via asset-based strategies. Methods We adopted a descriptive qualitative study design using focus group discussions. Twenty-seven older adults who either lived alone or with their spouses were purposively sampled from an elderly populated residential estate in Singapore. Six focus group discussions, conducted from December 2016 to May 2017, were audio-recorded, transcribed, and analyzed using thematic analysis. Results The themes that emerged were ‘tapping on internal self-care repository’, ‘maintaining and preserving informal social support’, and ‘enabling self by using environmental aids’, and an eco-map of aging assets was used to capture an overview of internal and external resources. With the repository of personal strengths, knowledge, and experiences, these older adults were generally resourceful in navigating around their resource-rich environments to cope with everyday life stressors and promote health. However, they were occasionally limited by individual factors that affected their comprehension, access, maintenance, and utilization of resources. Conclusion The eco-map of aging assets can be used as an assessment framework by community health practitioners to recognize, consider, and build a repertoire of resources among these older adults. It serves as a gentle reminder to adopt an ecological approach in considering and tapping into older adults’ wide-ranging personal, social, and environmental resources. Community health practitioners can support resource integration as resource facilitators via cognitive, behavioral, and motivational salutogenic pathways to overcome resource mobilization barriers faced by older adults. Such an approach helps older adults to find their internal capabilities and abilities to know who, where, what, and how to seek external resources to identify solutions, creating the intrinsic value to sustain their actions on resource utility.

SHAPE: A Healthy Aging Community Project Designed Based on the Salutogenic Theory

“…As such, the authors conducted a qualitative study employing the salutogenic perspective to explore the application of SOC concept [40] and mobilisation of resistance resources [41] among older community dwellers to obtain insights on how healthy aging could be promoted. The key findings from this study were thus applied in the development of the SHAPE intervention as described later in this chapter.…”

“…With lesser familial contact time and exchanges, senior-only household dwellers might receive lesser familial resources that are instrumental to healthy aging in their everyday lives. Based on the qualitative study the authors conducted on older adults residing in senioronly households in Singapore [41], family members are nevertheless amongst the wealth of health assets they utilised to promote and maintain their health. Apart from residing in a resource-rich external environment where the local government recently channelled considerable capital and support to create an age-friendly living city [61], older adults accrued an internal rich source of personal strengths, life disposition, experiences, self-care skills and knowledge, as well as social resources comprising family, friends, neighbours and social activities [41].…”

“…Based on the qualitative study the authors conducted on older adults residing in senioronly households in Singapore [41], family members are nevertheless amongst the wealth of health assets they utilised to promote and maintain their health. Apart from residing in a resource-rich external environment where the local government recently channelled considerable capital and support to create an age-friendly living city [61], older adults accrued an internal rich source of personal strengths, life disposition, experiences, self-care skills and knowledge, as well as social resources comprising family, friends, neighbours and social activities [41]. However, these older adults residing in senioronly households displayed variable levels of resourcefulness in gaining access, maintaining and utilising their health resources; some were less proficient in understanding and mobilising them [41].…”

“…Apart from residing in a resource-rich external environment where the local government recently channelled considerable capital and support to create an age-friendly living city [61], older adults accrued an internal rich source of personal strengths, life disposition, experiences, self-care skills and knowledge, as well as social resources comprising family, friends, neighbours and social activities [41]. However, these older adults residing in senioronly households displayed variable levels of resourcefulness in gaining access, maintaining and utilising their health resources; some were less proficient in understanding and mobilising them [41]. Furthermore, most of the older adults aged 65 years and above in Singapore received minimal years of education [62] and might not be information savvy.…”

“…The SHAPE-program consisted of 12 weekly group sessions, at least two home visits and a supplementary health resource book. Its curriculum was designed to address the stressors of healthy aging faced by senior-only household dwellers using their health assets/resistance resources [41]. Its content was drawn from the aging experiences of older adults residing in senior-only households to align health-promoting strategies, thereby meeting the demands and needs of their everyday lives.…”