Ballmer Thomas, Gantschnig Brigitte Elisabeth
Institute of Occupational Therapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland.
Department of Rheumatology and Immunology, University Hospital (Inselspital), University of Bern, Bern, Switzerland.
Br J Occup Ther. 2025 May;88(5):292-301. doi: 10.1177/03080226241306326. Epub 2024 Dec 20.
Older people with chronic conditions prioritize living arrangements that let them maintain their autonomy. However, many face activity limitations and participation restrictions. Stakeholders involved in their health and social care have a unique perspective on these challenges. The aim of this study was to examine how these stakeholders view the difficulties older people with chronic conditions living at home face in their everyday lives.
We conducted a qualitative descriptive study based on a focus group interview with eight stakeholders involved in health care, social care and housing for older people with chronic conditions. We transcribed the interview verbatim and analysed it using thematic analysis.
We generated four themes: fear of losing autonomy, inequality along socio-economic lines, persisting and new barriers, and 'what does "remaining living at home" really mean?'. Participants problematized the lack of awareness among key stakeholders for older people's needs and limited housing options beyond the dichotomous choice between ageing at home and in a care home.
Acknowledging diverse factors - fear of losing autonomy, socio-economic situation, limited awareness of key stakeholders, physical and other barriers, societal discourses - shaping older peoples' choices regarding their living arrangements informs how occupational therapists can support them.
患有慢性病的老年人会优先选择能让他们保持自主的生活安排。然而，许多人面临活动受限和参与受限的问题。参与他们健康和社会护理的利益相关者对这些挑战有着独特的见解。本研究的目的是探讨这些利益相关者如何看待患有慢性病的居家老年人在日常生活中所面临的困难。
我们基于对八名参与慢性病老年人医疗保健、社会护理和住房工作的利益相关者进行的焦点小组访谈开展了一项定性描述性研究。我们逐字转录了访谈内容，并使用主题分析法进行分析。
我们归纳出四个主题：对失去自主权的恐惧、社会经济层面的不平等、持续存在的和新出现的障碍，以及“‘居家养老’究竟意味着什么？”。参与者对关键利益相关者对老年人需求缺乏认识以及除了居家养老和入住养老院这种二分选择之外有限的住房选择提出了质疑。
认识到影响老年人生活安排选择的多种因素——对失去自主权的恐惧、社会经济状况、关键利益相关者的有限认识、身体和其他障碍、社会话语——有助于职业治疗师了解如何为他们提供支持。
