%0 Journal Article
%T Living with Uncertainty: Older Persons¡¯ Lived Experience of Making Independent Decisions over Time
%A Agneta Breitholtz
%A Ingrid Snellman
%A Ingegerd Fagerberg
%J Nursing Research and Practice
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/403717
%X The aim of the study was to illuminate the meaning of older persons¡¯ independent decision making concerning their daily care. Autonomy when in care is highly valued in the western world. However, research shows that autonomy can give rise to problematic issues. The complexity of independence and dependence for older people when living at home with help has also been highlighted. In Sweden, older people are increasingly expected to live at home with help from municipal home care services, and study into this aspect of care is limited. This study is a part of an ongoing project and has a qualitative life world perspective. Audiotaped narrative interviews were conducted and analysed using a phenomenological hermeneutic method. Findings revealed a main theme: ¡°living with uncertainty as to how to relate one¡¯s own independence and dependence with regard to oneself, and others.¡± This involves a constant process of relating to one¡¯s independence controlled by others or oneself, and adjusting one¡¯s independence and dependence with regard to oneself and others. The conclusion is that professional carers need to acknowledge the changing vulnerability of dependent older persons over time. The implication is a relational approach to autonomy beyond the traditional individualistic approach. 1. Introduction The care of the old, with an increasing population over 60 years old, presents a challenge worldwide [1]. In Sweden municipalities are responsible for the care of the old, and older people are now increasingly expected to live at home aided by municipal home help services. As a consequence older people¡¯s care needs have increased as well as the workload for professional carers [2]. Older people apply for support, and the help available includes laundry, cleaning, shopping, personal care, meals, and emergency alarms. Care managers assess their needs according to the Social Service Act, which requires that people¡¯s right to self-determination and integrity should be respected [3]. Autonomy when in care is highly valued in the western world and involves people¡¯s right to make their own choices without involving others [4¨C6]. Nevertheless, in the care of the old this individualistic approach to autonomy is problematic due to their dependence on others in their everyday lives [4, 7¨C9]. However, Sandman [6] argues that it is important to recognize that people value their autonomy differently. Further, it is therefore important to distinguish between different aspects of autonomy, that is, self-determination, freedom, desire fulfilment, and independence. The most central
%U http://www.hindawi.com/journals/nrp/2013/403717/