Adaptation of daily life functioning after disability : the case of Dutch older persons
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概要
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An extensive geriatric and medical body of knowledge exists to inform occupational therapy practice about possible adaptive strategies used by older people. Usually the focus is on specific disabling conditions, without taking other characteristics of the individuals' situations into account. The purpose of this study was to explore adaptation of functioning in daily life activities from the point of view of older persons with disabilities. For this study, adaptation was defined as "overcoming disabling influences on functioning in daily life activities". Method: Phenomenological (open in-depth) interviews. The informants were eight older Dutch persons with physical disabilities, who were receiving occupational therapy at home or in day-care). Results: 1) Descriptions of adaptation as a process that required these clients' active engagement: The clients used problem-solving strategies familiar from their past and personal resources as well as resources in their social and physical environments. Adaptation started with identifying prospects of potential solutions, followed by creating solutions to overcome constraints on occupational functioning. 2) The phenomenological analysis also resulted in descriptions of outcomes of adaptation. Adaptation was aimed at finding satisfaction through occupations. Satisfaction through occupations was found in maintaining daily routines and engaging in fulfilling occupations. 3) Finally, the analysis produced four meaning-dimensions that express how personal values influenced the adaptive processes. These were:"quite an endeavor","that's the way I do things","to lose a part of oneself", and "maintaining directorship". Recommendations for supporting older persons with disabilities were formulated, such as fulfillment as outcome-indicator, instilling hope and expectations, practice-situations that include family or other relevant persons, building on familiar problem-solving strategies, and the utility of narrative approaches.
- 藍野大学の論文