The art of maintaining everyday life: collaboration among older parents, their adult children, and health care professionals in reablement

Journal of Multidisciplinary Healthcare Dovepress open access to scientific and medical research Journal of Multidisciplinary Healthcare downloaded from https://www.dovepress.com/ by 185.210.218.199 on 31-May-2020 For personal use only. Open Access Full Text Article ORIGINAL RESEARCH The art of maintaining everyday life: collaboration among older parents, their adult children, and health care professionals in reablement This article was published in the following Dove Press journal: Journal of Multidisciplinary Healthcare Fanny Alexandra Jakobsen 1 Kjersti Vik 1 Borgunn Ytterhus 2 1 Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; 2Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway Background: A shift in the work-divide among generations and an ageing population have altered the balance of care and support between families and welfare states. Although state policy has increasingly acknowledged that older adults ageing in place receive support from family members, how adult children perceive their collaboration with their parents and health care professionals in reablement services remains unclear. The aim of this study is to identify how adult children perceive the collaboration between older parents, family members, and health care professionals in reablement services. Methods: This study has a qualitative research design with a constructivist grounded theory approach. In total, 15 adult children – 6 sons, 8 daughters, and a daughter-in-law, aged 47– 64 years – whose parents had received reablement services, participated in in-depth interviews. Results: Our findings clarify how children and their older parents’ reablement services can collaborate to support how the adult children manage and maintain both their own and their parents’ everyday lives. The core category derived from our data analysis was the art of maintaining everyday life, with four subcategories indicating the different dimensions of that process: doing what is best for one’s parents, negotiating the dilemmas of everyday life, managing parents’ reablement, and ensuring the flow of everyday life. Conclusion: To promote collaboration among older adults, their children, and health care professionals in reablement, health care professionals need to proactively involve older adults’ family members in the reablement processes, particularly because older adults and their children do not always express all of their care-related needs to reablement services. Keywords: rehabilitation, informal care, primary care, social need, grounded theory, next of kin Introduction Correspondence: Fanny Alexandra Jakobsen Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, N-7491, Trondheim 8905, Norway Tel +477 341 2798 Email 269 submit your manuscript | www.dovepress.com Journal of Multidisciplinary Healthcare 2019:12 269–280 DovePress © 2019 Jakobsen et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms. php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). http://doi.org/10.2147/JMDH.S195833 Powered by TCPDF (www.tcpdf.org) Adult children are often incorporated into the everyday life and care of their aging parents, even if their parents receive health care services. However, the relationship between those health care services and the children of older adults can be especially complex because neither party can readily achieve for older adults what the other can; their collaboration has the potential to enhance the care given.1 According to the World Health Organization,2 health care professionals should involve the families/next of kin of older adults in their care processes as well as keep them informed about their relatives’ health conditions, alert them to the health care services available to them, and offer them training and support in care delivery, especially when care-related needs are complex.3 However, regarding the exclusive ways in which families or health care services are responsible for the care of older Dovepress Journal of Multidisciplinary Healthcare downloaded from https://www.dovepress.com/ by 185.210.218.199 on 31-May-2020 For personal use only. Jakobsen et al adults, the boundaries remain unclear.4 In response, we sought to highlight how adult children perceive and experience their collaborations with siblings, parents, and reablement services in the care of their aging parents. Reablement, also called restorative care in Australia and the United States, refers to health care interventions involving public, community-based rehabilitation programs that aim to aid older adults, regardless of their condition, in performing their everyday activities, maintaining their independence, and maximizing their time out of health care facilities.5–8 Older adults who receive reablement services often exhibit decreased functioning or are at risk of such after experiencing an accident or period of illness.9 For older adults who have already received care from public health care services, reablement can reduce the need for such services.10 For health care professionals, collaborating with the family members of older adults in reablement can present dilemma regarding whether and, if so, when and how collaboration should occur.11 Their motives for not involving family members in reablement include wanting to maintain older adults’ autonomy and to allow older adults’ to decide to what extent, if any, their families participate in their care. By contrast, their motives for collaborating with older adults’ families can include needing to gather important information about the older adults’, wanting to improve a family’s attitude toward reablement by clarifying its purposes,9,12 and more generally, striving to ensure that families care for their ageing relatives once reablement ends.11 However, to those ends, health care professionals working in reablement services lack systematic approaches for collaborating with the families of their older adults.11 When involved in the everyday care of older adults in reablement, family members have reported assuming responsibility for various aspects of care, aiding with their older parents’ performance of practical tasks, having to negotiate with their par (...truncated)