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Active and non-active agents: residents' agency in assisted living
- Authors:
- PIRHONEN Jari, PIETILA Ilkka
- Journal article citation:
- Ageing and Society, 38(1), 2018, pp.19-36.
- Publisher:
- Cambridge University Press
Culturally, institutional care has been seen to strip older people of their status as full adult members of society and turn them into ‘have-nots’ in terms of agency. The substantial emphasis in gerontology of measuring the activity and functional ability of the elderly has unintentionally fostered these stereotypes, as have traditional definitions of agency that emphasise individuals’ choices and capacities. The aim of this paper is to discover what kind of opportunities to feel agentic exist for people who have reduced functional abilities and therefore reside in assisted living. In this paper, agency is approached empirically from the viewpoint of Finnish sheltered housing residents. The data were gathered using participant observation and thematic interviews. This study suggests that even people with substantial declines in their functional abilities may feel more or less agentic depending on their functional and material surroundings and the support they receive from the staff, relatives and other residents. The perception that residents’ agency in assisted living cannot be reduced to measurable activity has methodological implications for gerontological research on agency. Care providers can utilise our findings in reasserting their residents’ quality of life. (Publisher abstract)
Evaluating smart home technology in the Finnish context
- Author:
- HORELLI Lisa
- Publisher:
- STAKES. National Research and Development centre for Welfare and Health
- Publication year:
- 1994
- Pagination:
- 37p.
- Place of publication:
- Helsinki
Evaluation of how new technology can expand the scope of independent living for disabled people and older people.
Independent living with mobility restrictions: older people's perceptions of their out-of-home mobility
- Authors:
- LUOMA-HALKOLA Henna, HAIKIO Liisa
- Journal article citation:
- Ageing and Society, 42(2), 2022, pp.249-270.
- Publisher:
- Cambridge University Press
This study is about older people's perceptions of how they organise their out-of-home mobility and independent living when they face mobility restrictions, based on seven focus groups with older people (N = 28) from a suburb in Finland. This article provides an everyday life view of how the ability to move outside the home evolves through interdependencies between older people and their neighbourhoods, social relations and societal arrangements. The findings show that supportive socio-material surroundings can provide older people with new ways to move outside their home despite mobility restrictions and new ways to organise their daily life with decreased mobility. In contrast, restrictive socio-material surroundings can lead to situations in which older people forgo certain out-of-home journeys and activities. The findings contribute to an understanding that organising one's daily life and out-of-home mobility is an act of interdependence. Policies promoting independent living in old age should recognise these fundamental interdependencies and support versatile ways of living rather than overemphasise activity and self-reliance. Based on older people's everyday life perspectives, both sides of the coin need to be considered: how to enable the out-of-home mobility of older people facing mobility restrictions and how to support them in managing and enjoying daily life with decreased mobility. (Edited publisher abstract)
Social protection of older people in Finland from the eighteenth to the twenty-first centuries: messages for current policy and practice from an historical analysis
- Author:
- TOPO Päivi
- Journal article citation:
- British Journal of Social Work, 41(5), July 2011, pp.876-893.
- Publisher:
- Oxford University Press
This article explores how social protection of the elderly has evolved in Finland since the eighteenth century, and examines the influence of historical developments on current policy. It highlights two inter-connected themes in particular – the shifting levels of paternalism and the cycle from early ‘annual auctions’ through state provision to increased privatisation and commissioning of services. The shifting levels of paternalism show that there has been a shift from strong to weak paternalism and from the duties to the rights of people in their old age. Recent developments, however, show distressing indications of leaving the most vulnerable old people to fend for themselves in a complex care system. With respect to increased privatisation and commissioning of services, statistics show that more severe problems of health and functioning are now required before gaining access at higher charge to services of a quality that may have deteriorated. Abuse and violence are understood in this article as an issue of structural discrimination associated with old age, living in poverty or suffering from severe problems of health and functioning without access to necessary care and assistance. The implications for social work policy balancing protection and personalisation are discussed.
Let's blur the divide that's between staff and residents
- Authors:
- KOTALA Pirjo, SIUKOLA Katri
- Journal article citation:
- Journal of Dementia Care, 9(6), November 2001, pp.14-15.
- Publisher:
- Hawker
Describe a group of small homes for people with dementia in Finland which involve residents in every aspect of their running.
Perceived environmental barriers to outdoor mobility and changes in sense of autonomy in participation outdoors among older people: a prospective two-year cohort study
- Authors:
- RANTAKOKKO Merja, et al
- Journal article citation:
- Aging and Mental Health, 21(8), 2017, pp.805-809.
- Publisher:
- Taylor and Francis
Objective: The aim was to study whether perceived environmental barriers to outdoor mobility affect changes in sense of autonomy in participation outdoors among community-dwelling older people over a two-year period. Methods: Community-dwelling people aged 75-90 years (n = 848) in central Finland were interviewed on two occasions, face-to-face at baseline and over the telephone two years later. Perceived environmental barriers to outdoor mobility were assessed using a 15-item structured questionnaire, and the sum scores categorised into tertiles (0, 1 and 2 or more barriers). Autonomy in participation outdoors was assessed with the ‘Impact on Participation and Autonomy’ (IPA) questionnaire using the autonomy outdoors subscale (score range 0–20, higher scores indicating more restricted autonomy). Results: Scores for autonomy in participation outdoors were available for 848 participants at baseline and for 748 participants at the two-year follow-up. At baseline, those reporting multiple environmental barriers had the most restricted autonomy, while those reporting no environmental barriers had the least restricted autonomy. Over the follow-up, autonomy in participation outdoors declined more among those reporting multiple environmental barriers compared to those reporting none. Adjustment for cognitive functioning, education, number of chronic conditions and change in walking difficulty did not influence the association. Conclusion: Perceived environmental barriers to outdoor mobility accelerate the decline in autonomy in participation outdoors among older community-dwelling people. Understanding factors affecting autonomy can help in finding ways to support the sense of autonomy as people age. (Edited publisher abstract)
Is home care a realistic alternative to residential care among institutionalized elderly people in Finland?
- Authors:
- NORO A., ARO S.
- Journal article citation:
- Scandinavian Journal of Social Welfare, 5(4), October 1996, pp.249-258.
- Publisher:
- Munksgaard/ Blackwell
The high rate of institutionalisation among elderly people in Finland is widely among policy-makers. Studies how realistic the wishes for deinstitutionalisation are among the least sick elderly people in residential care, and what patient characteristics predict whether residential care is appropriate. This issue was assessed by the residential home personnel. Personnel assessment of institutional care as appropriate was mainly explained by patients' needing help with medication, limitations in activities of daily living, absence of own home return to, no living children, incontinence, and poor vision. Discharging elderly people from long-term residential care back to society is limited by factors such as inadequate housing and shortage of domiciliary care and rehabilitative services, as well as by attitudes among the institutionalised elderly people themselves. It seems more realistic to prevent the inappropriate institutionalisation of elderly people that to discharge the small numbers of fairly independent individuals already in residential homes.