Changes in everyday life after discharge from day care rehabilitation

Community-based day care that provides rehabilitation (DCR) targets elderly people with physical disabilities. The goal of these programmes is mainly to improve physical ability in order to enable participants to remain in their ordinary homes. Knowledge of the outcomes of DCR is limited as well as knowledge of what it is that makes a difference for the individual. The aim of this study was to describe what changes in everyday life elderly persons experienced after discharge from a community-based day care rehabilitation centre and to give possible explanations for these changes. Fifteen elderly people were interviewed after that they had been discharged from DCR. A narrative approach was used for analysing the interview data. Four case stories constitute the findings, each of them with unique descriptions of changes in everyday life as well as possible explanations for these changes. The first case story described resumption of daily activities that made the days more eventful and meaningful. The second described how everyday life became an arena for exercising, which create confidence for the future. The third described how an increased sense of certainty and security in the movements led to an increased appetite for life. Finally, the fourth case story described both the stay at the DCR centre and the promise of a new period there as uplifting that made the days easier. Concerning possible explanations for these changes, the findings indicate that it was a combination of several events that together contributed to the changes. Examples were physical training, counselling about how to live in an active and healthy lifestyle, and socialisation with other patients in formal as well as in informal sessions

Äldre personers dagliga liv och betydelsen av dagrehabilitering

The overall aim of this thesis was to study elderly persons’ everyday life and the benefits of community-based day care rehabilitation (DCR). Further aims were to describe everyday life as experienced by elderly persons eligible for DCR and what they expected to gain from attending DCR. Participants in  study I and II were 22 prospective elderly day-care patients with physical disabilities. Interviews about their experiences of everyday life (study I) and their expectations of DCR (study II) were conducted and analysed according to a qualitative research approach called phenomenography. In study III 15 elderly persons were interviewed about changes in everyday life after having been discharged from DCR. A narrative approach was used for analysing the interviews. In Study IV occupational therapy patients’ records from 59 patients that had been discharged from DCR were analysed using deductive content analysis for describing individual treatment goals and level of goal attainment. The findings in study I, showed that cessation of activities and social contacts resulted in feelings of resignation and dejection for some participants. Participants also described how activities and social contacts continued, albeit in a different way, and that being active resulted in feelings of pleasure. In study II the findings described expectations of participating in physical training and socialisation with others at the DCR. The findings in study III, in the form of four case-stories, described positive changes in the participants’ everyday life such as improved occupational performance and heightened sense of wellbeing. The findings indicate that it was a combination of several events that together contributed to the changes. The findings in study IV showed that “Walking” was the category that contained the highest proportion of treatment goals. A majority of the treatment goals were either completely achieved or partially achieved. DCR could have a significant impact on elderly persons’ everyday life