Older people's occupations. A life with and without work. : A life with and without work

Sammanfattning: Introduction: The demographic changes with population ageing and a rapidly growing share of very old peoplewill put an increasing pressure on the health and social care system. In order to both restrict early retirement and force people to extend their working life reforms are changing pension systems in many European countries. Besides that older people have to extend their working life it is important to optimize opportunities for valued occupations and a variation of occupations that contributes to health for older people. However, how work may contribute to occupational engagement among older people also in a long-term perspective are scarcely studied. Aims: The overall aim of the thesis was to deepen the knowledge about engagement in occupations among people from the age of 55 to very old age.Methods: Cross sectional and longitudinal cohort designs were used in this thesis. Studies I and II were based on a purposeful selection of participants from three different work domains: construction and technical companies and community elderly care sector (n=24,Study I; n=26, Study II). In Study III respondents from the Scania Public Health Cohort age 55 and over working at least 10 h/week at baseline and not working at follow- up were included (n=1098). Study IV is based on a strategically selection of participants from ENABLE- AGE Survey study, all beyond age 80 (n=21). Data was collected through focus groups (Studies I- II), individual interviews (Studies II and IV), and a postal questionnaire (Study III).Results: The findings showed that work was considered important and valuable especially with regard to how challenging work tasks were, the possibilities for inclusion in a team of colleagues and the chances for better personal finances (Study I). Organizational factors such as possibilities to influence work tasks, working time and skills development supports the willingness for an extended working life (Study I). Based on values and personal meaning of occupations the participants in Study II had changed their occupational pattern for a more harmonious mix of occupations which contributed to experience of occupational balance. Multivariate logistic regression in Study III showed that jobs with high control, seem to predict high social participation, also after cessation of employment. The results also suggest that high social participation during working life is a predictor of high social participation in a long-term perspective (Study III). A wish to keep on doing as before was evident in Study IV but personal as well as environmental barriers made it difficult especially social participation. Much work in working life without time for leisure seemed to lead to few interest also in very old age.Conclusions: A supportive work environment with possibilities for employees to participate in decision making is beneficial also after retirement. A sustainable working life is a prerequisite for a higher retirement age and may support people to work at least until retirement age and maybe even longer.