Elderly persons’ expectations of day-care rehabilitation
´ ANITA TOLLEN, CARIN FREDRIKSSON & KITTY KAMWENDO
¨ Department of Health Sciences, Orebro University, Sweden
Abstract The aim of this study was to explore elderly persons’ conceptions of what they expected to gain from attending day-care rehabilitation centres (DCR). A purposeful sampling procedure was employed. Interviews with 22 prospective elderly daycare patients were carried out and analysed according to a phenomenographic approach. The analysis yielded eight categories. Two categories, Social contact and Exercise , described what the elderly persons expected to encounter. The remaining categories, A change from the monotony of everyday life , An opportunity to be yourself , A balm for the body, A safety net , A mastery of everyday activities , and An energizing spark , described the meanings of the encounters. Two categories were attributed to the elderly persons’ physical presence at the centre and the gains were expected to end when the programme ended. In three categories the expected improvements were projected into the future and were expected to last. The findings imply that follow-up home visits and suggestions for alternative social activities in order to provide stimulation and social equality would be a valuable complement to the DCR programme. Rehabilitation personnel need to consider the ambivalent view on assistive devices as well as the elderly person’s need for continuity when setting goals and planning individual programmes.
Key words: Community-based adult care, disability, qualitative research, phenomenography
Introduction In Sweden, as in other countries, many elderly persons with disabilities live in their own homes rather than institutions. In 2004, 98% of all elderly Swedish persons between 65 and 79 years and 83% of all persons 80 years and over lived in ordinary housing (1). It is difficult to estimate how many of these persons may have physical disabilities but data derived from the annual survey of living conditions conducted by Statistics Sweden (2) showed that 81% of persons between 65 and 84 years (n 0/1 095) reported long-term illness, problems following an accident, handicap or other weakness. In a study by Thorslund et al . (3), one aim was to investigate health and living conditions among persons aged 77 and over (n 0/561): the result showed that about 60% had limitations in their ability to stand and move around, and about 57% had a decreased range of motion, strength and balance. According to estimates made by Statistics Sweden (4) the number of elderly persons aged 65 years and over will
increase by 21% during the next decade. Consequently one can assume that the number of elderly persons with disabilities will also increase. The principle of enabling persons to remain in their homes for as long as possible is a central principle in Swedish welfare policy and the municipalities provide a number of services such as meals, home help, and other forms of adult day care to facilitate this (5,6). Community-based adult day care has emerged in recent decades (7 Á9). Programmes vary for different groups and are designed to meet the varying social and/or health needs of elderly persons in accordance with their disabilities (7,8,10). The ultimate goal is to enable people with disabilities to continue living at home (9Á12) and to facilitate social contacts (1). In Sweden there are different types of community-based day care for the elderly. One type called ‘‘day care that provides rehabilitation’’ (DCR) is aimed at improving physical ability. Each patient is offered an individual programme worked out by professionals, i.e. occupational
¨ ¨ Correspondence: Anita Tollen, Department of Health Sciences, Orebro University, SE-701 82 Orebro, Sweden. Tel: '46 19 30 37 41. E-mail: ´ / firstname.lastname@example.org
(Received 10 March 2006;...