Carrying on life at home or moving to a nursing home: frail older people’s experiences of at-homeness

Aims and objectives The aim was to explore frail older people’s lived experiences of managing life at home on the verge of moving to a nursing home. Background As people age, their reserve capacity decreases, increasingthe risk of morbidity and frailty.. The experience of frailty extends beyond declining health and physical well-being and encompasses various dimensions, including familiarity with both the place and the people around. Design A phenomenological study. Methods We interviewed ten frail people aged 72–90 years in-depth in their homes. We used phenomenological hermeneutical analysis inspired by van Manen and followed the COREQ checklist. Results We identified three main themes: (1) being home with cherished people and possessions, (2) giving the nursing home a go and (3) attuning to the natural rhythms. Conclusions Our study gives insight into the lived experiences with frailty related to at-homeness. The experience of being lost in transition represents a uniquely significant experience for frail older people, foregrounding existential issues and carrying the potential of at-homeness.publishedVersio

Caregiving for frail home-dwelling older people: A qualitative study of family caregivers' experiences

Background The increasing frailty of home-dwelling older people can lead to rising expectations from their family caregivers due to various demographic developments and political guidelines. European data show that 60% of home-dwelling older people receive informal care. Frailty among older people is a state of vulnerability, increasing the risk of adverse health outcomes, declining daily activities and needing long-term care. Aim To explore family caregivers' lived experiences with caring for frail, home-dwelling older people. Methods We conducted a phenomenological study to obtain in-depth descriptions of the phenomenon. We interviewed nine family caregivers, five men and four women between 52 and 90 years old, in-depth in their homes. We used a hermeneutical phenomenological approach described by van Manen and followed the COREQ checklist. Results The phenomenon's essential meaning is described as striving to adapt throughout the caring relationship. The interrelated themes describe different caring relationships, caring for a family member and letting go of the primary caring responsibility. Conclusions Family caregivers describe care as meaningful yet demanding. In our study, the varying condition of frailty was an additional challenge in care. By addressing these challenges, healthcare providers can better support and help family caregivers to withstand their caring relationships. The Norwegian Centre for Research Data approved the study (Ref.61202).publishedVersio

In the borderland of the body: How home-dwelling older people experience frailty

Rationale The increasing number of frail home-dwelling older people has sharpened the focus on discovering and implementing suitable treatment and care in clinical practice, aiming to prevent loss of physical functioning and preserve their autonomy and well-being. People's embodied experiences may yield rich descriptions to help to understand frailty. Thoroughly understanding older people's individual perceptions is especially relevant because the numbers of home-dwelling older people are increasing, and people tend to develop more health problems and become frailer as they age. Their perspectives are important to develop knowledge and high-quality care. Aim To explore the lived experiences of frail home-dwelling older people. Methods We conducted a phenomenological study to obtain in-depth descriptions of the phenomenon. We interviewed 10 home-dwelling older adults (seven women and three men, 72–90 years old) in depth about their lived experience of frailty. We analysed the data using a hermeneutic phenomenological approach described by van Manen. Findings The lived experience of frailty is described in one essential theme: frailty as being in the borderland of the body, including three interrelated subthemes: (1) the body shuts down; (2) living on the edge; and (3) not giving up. Conclusions Our study gives insight into lived experiences with frailty among home-dwelling older people related to their own body. Older people's experience of meaningful activities strengthened their feeling of being themselves, despite their frail and deteriorating body. Healthcare providers must consider the strategies of frail older people to consider both their vulnerabilities and self-perceived strengths. The resources and deficits of frail older people present in the state of being frail need to be recognised.publishedVersio

Lived experiences of frailty among home-dwelling older people and family caregivers

Background: The aging population, increasing incidence of frailty with age and increased risk of reduced ability to carry out everyday activities reveal the challenges for the individuals living with frailty, their caregivers and the health-care system. Aim: This study aimed to explore the lived experiences of frail home-dwelling older people and their family caregivers. Methods: The study had a qualitative design rooted in phenomenology. Central theoretical perspectives are anchored in Heidegger, and the existential terms lived body, lived place, lived relationships and lived time were used in the analysis work. The in-depth interviews with 19 participants, 10 frail older people and nine family caregivers 54–90 years old, in their own homes, provided rich material. Findings: The first article explores the lived experiences of frail home-dwelling older people related to the body and the participants’ balancing act between frailty, strength and the constantly changing body. In the second article, we explored the experiences of coping with life at home on the verge of moving to a nursing home. In the participants’ situation, regaining a feeling of being at home was essential, regardless of where they lived. In the third article, we explored the experiences of family caregivers who struggled to adapt to a caregiving process that was meaningful but also unpredictable and demanding. Conclusion: Frail home-dwelling older peoples' interaction with their surroundings changed as the body gradually lost its earlier capacity. Yet, they had the strength and vitality to continue their lives at home with support from others. Family caregivers lived double lives and had to care for their families, work and social life, and the caring responsibility could overwhelm their capacity, even if they tried to prepare. Consequences: Frailty can overshadow vitality, and health-care personnel can be aware of this when they provide and plan care for these people. Including frail older people and family caregivers in planning care is crucial to determine what is essential to manage life at home now and in the future.Bakgrunn: Ei aldrande befolkning, aukande førekomst av skrøpelighet med alderen, og nedsett evne til å utføre daglegdagse aktvititetar, synleggjer utfordringane for den enkelte som lever med skrøpelighet, deira pårørande og helsevesenet. Mål: Denne studien hadde som mål å utforske dei levde erfaringane til heimebuande eldre som lever med skrøpelighet og deira pårørande. Metode: Studien har et kvalitativt design forankra i fenomenologi. Dei gjennomførte djupneintervjua med 19 deltakarar, ti eldre som levde med skrøpelighet og ni pårørande i alderen 54-90 år, i deira eigen heim, gav eit rikt materiale. Sentrale teoretiske perspektiv er forankra hos Heidegger. Eksistensialene levd kropp, levd stad, levde relasjonar og levd tid vart brukt i analysearbeidet. Funn: Den første artikkelen utforska dei levde erfaringane til heimebuande skrøpelege eldre relatert til kroppen, og deltakarane sin balansegong mellom skrøpelighet, styrke og en kropp i stadig endring. I den andre artikkelen utforska vi erfaringane med å meistre livet i grenseland mellom heim og sjukeheim. I situasjonen deltakarane var i, var det viktig å gjenvinne ei kjensle av å kjenne seg heime, uavhengig av kvar dei budde. I den tredje artikkelen, utforska vi erfaringane til pårørande som streva etter å tilpasse seg ein omsorgsprosess som var meiningsfull, men også uføreseieleg og krevjande. Konklusjon: Samhandlinga skrøpelege heimebuande eldre hadde med omgjevnadane endra seg ettersom kroppen gradvis miste sin tidlegare kapasitet. Likevel hadde dei styrke og vitaliteten til å bu heime med støtte av andre. Pårørande levde doble liv, der dei måtte ta seg av eigen familie, arbeid og sosialt liv, og omsorgsansvaret kunne overgå kapasiteten deira, sjølv om dei prøvde å førebu seg. Konsekvensar: Skrøpelighet kan overskygge vitalitet, og helsepersonell bør vere klar over dette når de yter og planlegg omsorg for desse menneska. Å inkludere skrøpelege eldre og pårørande i planlegging av omsorg er avgjerande for å finne ut kva som er nødvendig for å klare livet heime no og i framtida.Doktorgradsavhandlin

End-of-life care at home : Dignity of family caregivers

publishedVersio

Lost in transition? How frail older people experience at-homeness

Background The experience of frailtyextends beyond declininghealth and physical wellbeing and encompassesvarious dimensions,including physiological andsocial functioning.Research questionThe research questionguiding our study was: Howdo frail older peopleexperience at-homeness?MethodFrom a purposive samplingstrategy, ten frail people72–90 years old wereinterviewed in depth in theirhomes. We usedphenomenologicalhermeneutical analysis andfollowed the COREQchecklist. The study waspresented to the WesternNorway RegionalCommittee for Medical andHealth Research Ethicsand approved by theNorwegian Centre forResearch Data (Ref.61202). DiscussionOur study highlights that frailty disruptedparticipants’ rhythm and continuity ineveryday life at home. Short-term stays ata nursing home further forced participants’lives into a new rhythm not in tune withtheir own. FindingsAn overall finding was that theparticipants wanted to regain a feeling ofat-homeness in their experience of notbeing at home. We identified three mainthemes: (1) being home with cherishedpeople and possessions, (2) giving thenursing home a go and (3) attuning tothe natural rhythms. For home-dwellingfrail older people, life is balancingbetween living safely in their own homeor needing to move into a nursing home. ConclusionsOur study provides insight into the livedexperiences with frailty related to athomeness. The experience of being lostin transition represents a uniquelysignificant experience for frail olderpeople, foregrounding existential issues,carrying the potential of at-homeness

Carrying on life at home or moving to a nursing home: frail older people’s experiences of at-homeness

Aims and objectives The aim was to explore frail older people’s lived experiences of managing life at home on the verge of moving to a nursing home. Background As people age, their reserve capacity decreases, increasingthe risk of morbidity and frailty.. The experience of frailty extends beyond declining health and physical well-being and encompasses various dimensions, including familiarity with both the place and the people around. Design A phenomenological study. Methods We interviewed ten frail people aged 72–90 years in-depth in their homes. We used phenomenological hermeneutical analysis inspired by van Manen and followed the COREQ checklist. Results We identified three main themes: (1) being home with cherished people and possessions, (2) giving the nursing home a go and (3) attuning to the natural rhythms. Conclusions Our study gives insight into the lived experiences with frailty related to at-homeness. The experience of being lost in transition represents a uniquely significant experience for frail older people, foregrounding existential issues and carrying the potential of at-homeness. Relevance to practice To unleash frail older people’s potential for at-homeness, health professionals must meet the needs of frail older people individually. Going beyond signs and symptoms to reveal people’s concrete everyday experiences is crucial to understanding frailty

In the borderland of the body: How home-dwelling older people experience frailty

Rationale The increasing number of frail home-dwelling older people has sharpened the focus on discovering and implementing suitable treatment and care in clinical practice, aiming to prevent loss of physical functioning and preserve their autonomy and well-being. People's embodied experiences may yield rich descriptions to help to understand frailty. Thoroughly understanding older people's individual perceptions is especially relevant because the numbers of home-dwelling older people are increasing, and people tend to develop more health problems and become frailer as they age. Their perspectives are important to develop knowledge and high-quality care. Aim To explore the lived experiences of frail home-dwelling older people. Methods We conducted a phenomenological study to obtain in-depth descriptions of the phenomenon. We interviewed 10 home-dwelling older adults (seven women and three men, 72–90 years old) in depth about their lived experience of frailty. We analysed the data using a hermeneutic phenomenological approach described by van Manen. Findings The lived experience of frailty is described in one essential theme: frailty as being in the borderland of the body, including three interrelated subthemes: (1) the body shuts down; (2) living on the edge; and (3) not giving up. Conclusions Our study gives insight into lived experiences with frailty among home-dwelling older people related to their own body. Older people's experience of meaningful activities strengthened their feeling of being themselves, despite their frail and deteriorating body. Healthcare providers must consider the strategies of frail older people to consider both their vulnerabilities and self-perceived strengths. The resources and deficits of frail older people present in the state of being frail need to be recognised

Carrying on life at home or moving to a nursing home: frail older people’s experiences of at-homeness

Aims and objectives The aim was to explore frail older people’s lived experiences of managing life at home on the verge of moving to a nursing home. Background As people age, their reserve capacity decreases, increasingthe risk of morbidity and frailty.. The experience of frailty extends beyond declining health and physical well-being and encompasses various dimensions, including familiarity with both the place and the people around. Design A phenomenological study. Methods We interviewed ten frail people aged 72–90 years in-depth in their homes. We used phenomenological hermeneutical analysis inspired by van Manen and followed the COREQ checklist. Results We identified three main themes: (1) being home with cherished people and possessions, (2) giving the nursing home a go and (3) attuning to the natural rhythms. Conclusions Our study gives insight into the lived experiences with frailty related to at-homeness. The experience of being lost in transition represents a uniquely significant experience for frail older people, foregrounding existential issues and carrying the potential of at-homeness