Strategies older New Zealanders use to participate in day-to-day occupations
This exploratory study investigated the strategies that eight older New Zealanders use to enable participation in day-to-day occupations that they need or want to do, in their homes and the community. The types of strategies older people use to overcome barriers to participation and manage limitations are not widely known or reported. Exploring strategies for participation employed by older people is important because the majority of older New Zealanders live in the community and their numbers are growing, and projected to reach 25% of the total population by the year 2051 (Ministry of Health, 2002). New Zealand’s Positive Ageing Strategy (Minister for Senior Citizens, 2001), advocates for a society where people can age positively, where they are highly valued and their participation encouraged. The literature relating to occupation, participation and health was explored, and provided some evidence that older people are developing strategies and, with some education, are able to manage their own health conditions. The assumption underpinning this study is that they are equally able to manage strategies for participation, particularly those devised by older people themselves. A qualitative descriptive methodology was used. The participants were selected following a presentation to a group of older adults and snowball recruitment. They were aged between 73 and 98 years old and were receiving assistance to live in community, which was taken to indicate they had experienced some limitation in, or barrier to their everyday activities, in response to which they might have discovered or developed coping strategies. Interviews were conducted in the participants’ homes, and analysed using a general inductive approach. Four main categories emerged; strategies for keeping me safe, strategies for recruiting and accepting help, strategies for meeting biological needs, and strategies for conserving resources. Overarching themes of managing and getting on with it, sprinkled with a sense of humour by some participants was present in the attitudes of many participants. The study revealed that this group of older people can and do use strategies to enable occupation in their everyday lives, which differ from those recommended by occupational therapists and other health professionals. This finding suggests that health professionals, policy makers and educators have much to learn from older people. The provision of help to older adults should take into consideration the importance of social interactions, not just the physical needs. There is a need for transport to be more readily available and affordable for older people to attend occupations that meet social needs. Health professionals complement the strategies developed by older people, and finding ways to combine the strategies should be developed. Listening to older adults’ current ways of managing and working with them to develop alternate, yet acceptable methods will provide a challenge. Health professionals should take a greater role in advocating for the social and transport needs of older adults. A self-management approach in education for older people, using peers and making use of existing education groups in the community and health system, is suggested. Education of those who engage with older people, such as carers, family, health professionals and community groups should include developing their skills in assisting older people to identify their strategies and developing strategies for the future.