Successful Ageing of Frail Elderly - Able - Annette Johannesen

SAFESuccessful Ageing of Frail ElderlyProject located atThe Danish Institute of Gerontology.Supported byThe Health Insurance Fund andThe Municipal VAT- Fund.SAFE / Anette Johannesene-mail: johannesen@geroinst.dk

AimProject SAFE aims at deeper understand why some85-year frail persons experience satisfaction in everydaylife despitetheir state of weakness and to use thisknowledge in preventive intervention.Focus of this study is coping abilities and ways offacilitating a beneficial ageing process.SAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Population cohort studyof persons born 1914The Research Centre for Prevention andHealth, Copenhagen County, Denmark.The investigation year 2000 isthe 7.th of this population cohortSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Study population• 403 persons - all 85 years old - were invited• 243 persons accepted to receive home-visit by an OT(Participation rate 61%)• Population was restricted to 187 frail persons:(69 men and 118 women)SAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Participants are categorisedas not frail if they are able to• transfer and to walk around indoors• get outdoors• walk outdoors for half an hour in nice and in poorweather• go up the stairs to second floorWithout feeling tired or needing helpSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Successful Ageing asEveryday life satisfactionSuccessful ageing wasmeasured by positiveanswers to• satisfaction with the dailyround• satisfaction with life• satisfaction with contact toothers.SAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Successful ageingas a procesSuccessful ageing is seen as a process includingadaptive strategies ’SOC’• Selection• Optimisation• CompensationBaltes & Baltes 1991SAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Coping abilitiesEveryday life satisfaction seems connected topersonal coping abilities such as selective optimizationwith compensation when meeting changed conditions.SAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Question• Are You occupied in daily life as usual?Yes, moreYes, as usualNo, lessComments:______________________________SAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Experiencing everydaylife satisfaction• I used to love doing my garden, now I enjoy goingfor a walk• I like to sit down when working now• Earlier I enjoyed to knit, now I listen to music moreand moreSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

- and not experiencingeveryday life satisfaction• I do as little as possible now, would like to dosomething• I enjoyed the days when I was able to go shopping• I cannot keep my house, I cannot do cooking, orbaking cakesSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Development ofcoping abilitiesIt can be questioned if such adaptive strategies arepossible to learnThrough preventive home visitsThrough general health promotionThrough information on available servicesThroug study groups….SAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Well-being andexpectationsPeople with different expectations will reportdifferently, even when the have the same conditions.To perceive well-being, the environmental servicesmust meet the expectations of the individual *.* Eggert PetersenSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Facilitating a beneficialageing process.Recommandations according to this study:• Ask for different dimensions of satisfaction• Notice if the person have adaptive strategies• Listen well to the expectations of the individualSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Further investigationsQualitative interviews with remarkablesurvivors to increase understanding of theirbeneficial ageing processFocus:ExpectationsCoping strategiesSort of servicesSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Environmental factorsThe present study provide evidence that old personswith poor functional ability are more likely to experienceeveryday life satisfaction if they:• are able to continue usual activities• can stay in own home without help• have friends, preferable more than twoSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Social PolicyThe findings underpin the Danish social policy ofhelping disabled persons to stay as active andindependent of help as possible.Furthermore supporting social relations / friendhipsamong the oldest old who risk loosing dear onesSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Occupational ScienceEngagement in occupation seems related to healthif the person experienceControl, motivation, social relations,challenge, or use of own resourcesSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Perception of change in daily roundfor satisfied frail elderly+ -Control171322Stress/imbalanceBoredomDeprivationSocial relationsUse own ressources4138FailureSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Occupational ScienceEngagement in occupation seems not related to healthif the person experienceStress, imbalance, deprivation, boredom, or a senseof failureSAFE / Anette Johannesene-mail: johannesen@geroinst.dk

Perception of change in daily roundfor not satisfied frail elderly+ -ControlSocial relationsUse own ressources52722Stress/imbalanceFailure1211BoredomDeprivation18SAFE / Anette Johannesene-mail: johannesen@geroinst.dk