It’s my party : opportunities for older adults to influence everyday activities in a nursing home setting

Sammanfattning: The overall aim of the thesis was to contribute with knowledge about how influence was enacted and negotiated by nursing home residents in everyday activities. The thesis applied a dialogical approach, incorporating theoretical resources from occupational therapy and social sciences. Methodologically this thesis applies a collaborative approach. The thesis was conducted in a nursing home in Stockholm and encompassed four qualitative studies that informed each other and together provide a comprehensive understanding of the influence of nursing home residents on everyday activities. The studies involved the nursing home community as a whole, including residents, staff and policy documents. The methods included narrative ethnography, collaborative design, both with nursing home residents and staff, as well as a critical discourse analysis. The findings from the four studies were synthesised through a hermeneutical analysis. From the analysis, three general findings emerged: The first general finding: Problematising the experience of “Everything will work out just fine” shows that everyday activities in the context of a nursing home play a pivotal role in helping the residents feel at home in the world and for the maintenance of their identities. However, everyday activities are managed top-down with limited collaboration with the nursing home residents because of the strong institutional character of the setting. This then leads to everyday life being experienced as fragmented and disrupted. The second general finding: Regaining crucial qualities of everyday life illustrates that when nursing home residents are treated as being resourceful, they can significantly influence their everyday activities and contribute to a sense of community. Such influence in everyday activities can enable the residents to reconnect with qualities of everyday life such as familiarity, fellowship and joy. In this regard, nursing home staff play a crucial role in both creating and upholding opportunities for the residents to enact their influence in everyday practices. The third general finding: Understanding passive activity: The juncture between every practices and policies uncovers how everyday activities are located at the juncture between societal discourses and everyday practices. This gives a broader understanding of a number of underpinning dynamics that position nursing home residents as passive recipients of care. A conclusion of this thesis is that the influence of nursing home residents on everyday activities may be possible but is not evident in current practices. Another conclusion is that influencing in everyday activities could provide a more recognisable character to everyday life, a key issue when living with cognitive decline and other chronic conditions. Taking into account that everyday activities played a key role for the nursing home residents, it is crucial to critically revise the role of occupational therapy, as a discipline, in nursing home contexts.