Older adults' conceptions of home and experiences of living with long-term musculoskeletal pain at home

Sammanfattning: Worldwide there are an increasing number of older adults, many of whom desire to age in place, remaining at home. This makes home increasingly important for health care delivery. Long-term musculoskeletal pain often accompanies old age and is one of the most prevailing and disabling health problems among community dwelling older adults. However, limited research exists on older adults' conceptions of home and their experiences of living with musculoskeletal pain at home. Nurses need this kind of understanding for individualized and holistic care of older adults living at home.Three studies were conducted. The Hybrid Model for Concept Development was used to define the concept of home and its meaning in the lives of three older women. Home consisted of three components, place, relationship and experience and was defined as a place to which one is attached, feels comfortable and secure and has the experience of dwelling. Secondly, hermeneutical text interpretation was used to understand the experience of home from interviews with six older adults. Home was intimate and integral to one's sense of being and life itself. Participants could not really imagine living without it. There was an underlying tension and fear of being forced to leave home one day. Lastly, qualitative interviews with 19 older adults, phenomenography and content analysis, were used to describe differences and commonalities in the experience of living with long-term musculoskeletal pain at home. Four ways of dealing with daily life were identified: ignore, struggle, adjust and resign. Participants learned how to endure pain in their daily life. Common themes included: taking the pain as it comes, one day at a time; balancing the pain with activity, thoughts and emotions; self talking; trying to be less of a burden to family and others; capturing, enjoying and valuing moments of pleasure. Three major concepts in symbolic interactionism: role, negotiation and meaning making illuminated findings. Increased understanding of home among older adults and the enduring associated with living with long-term musculoskeletal pain may enhance the quality of life at home, preserve and promote the older adult's sense of being at home, health and overall well-being and maximize care and minimize intrusion.