Influence in everyday life and health care for frail old persons

What everyday influence do frail older persons identify as important both achieved and missing for them? How do frail older persons integrate their desire for everyday influence with experience by themselves and others of possible declining cognitive, emotional and physical capabilities? What staff, physical space, socio-cultural, funding and policy conditions within home-based or institution-based health and social care services present opportunities or challenges for frail older persons to assert everyday influence they identify as important?

Study design, materials, methods

The project builds on two on-going multiple-method and ethnographic projects by the research group:

1. A tailored home rehabilitation for frail older persons developed with professionals in rehabilitation, as well as an initiative for an advisory body of former patients who are now living at home funded by guest researcher grant from FAS, Dr Arlene Katz, Harvard Medical School and pioneer in developing partnerships with frail older persons. These projects are located at a rehabilitation unit in Stockholm, and led by Professor Lilja at Luleå University of Technology, Professor Josephsson and Dr Johansson at KI.
2. The project "Creating Inclusive Communities" conducted in Stockholm and Kobe (Japan), in which the method "photo voice" is used to visualize older migrants' perspectives and experiences led by Dr. Asaba). In line with ethnographic methodology our project idea will create 20 detailed portraits with critical analyses of the opportunities and challenges for frail older persons to assert everyday influence as they engage in everyday life as well as when using health and social services Data for 10 portraits will be collected in Stockholm (large urban) and 10 in Luleå (small urban). Policy documents on health and social service for frail older persons will be collected by the research team. Though each person’s local life experience will differ, where the interpretations and analysis identify points of generalizability about the Swedish health and social system, the researchers will raise those points in Dialogue Forums in Year 3, and in future research. Participants diagnosed as frail and based at home will be recruited from each site through purposeful sampling (Kaufman 1994). Five qualitative methods will be woven to develop an ethnographic portrait of everyday influence for frail older persons including 1. observation, 2. photovoice, 3. interviews, 4. document analysis, and 5. sustainability dialogue forums. This interweaving of multiple perspective and methods will empower frail older persons who share collective interests, resources and needs). It will also triangulate the data from the diverse perspectives of frail, older persons, volunteer support persons to these people, professionals, and academic researchers.

Project leaders