Perceptions of physical activity among older people and staff in residential homes
In this paper, I will describe how people define the concept of physical activity and how they understand this phenomenon. This is a part of my PhD-studies, focusing on opportunities to be physically active and factors that may affect the possibilities in residential homes.
Physical activity is often described as positive and important for all people. Physical activity when moving to a residential home can be problematic when people often are in high age and have major disabilities and diseases, which may affect the physical ability (SOU 2008:113).
There are several researchers who have defined the concept of physical activity. A common definition of physical activity is Caspersen et al (1985) definition; “Physical activity is any bodily movement produced by skeletal muscles that result in energy expenditure”. The effects of physical activity have been described in many studies. Swedish Council on Technology Assessment has done a compilation of studies on various methods to promote physical activity (SBU 2007). It describe that a physical active lifestyle reduces the risk of developing various diseases. Physical activity has a secondary preventive effect when the disease has already occurred may be affected. This is said to also apply to older persons. Public Health Institute has published with advice based on current research findings on how physical activity can be used to prevent and treat various diseases (FYSS 2008). It explains that physical activity and exercise can help prevent and reduce the number of age-related physical and psychological changes in the body. Welmer et al. (2012) have made interviews with people in the age of 80-91.The old people describes that they did not see physical activity as a self-defined activity but as a consequence of other activities (social aspects) that are perceived as more important than the actual physical activity. Some people described that morning exercise or a walk gave more energy and gave a better mood while others described the care of things in their own home, such as make the bed, washing dishes and being able to take care of things in the garden, as important. There was also some that described these activities as boring but necessary, and nothing they did because they really wanted. Some people in the study wanted to do things for themselves, while others wanted to be with others.
Studies point out that when the elderly person's own opinions, desires and needs must be reflected in efforts to promote occupational performance so increasing their motivation to participate Activities that take place at senior housing is often done in groups. The supply to meet an individual's needs for physical activity is very limited. Staff perception of lack of time is a likely reason why collective activities priority over individual. It could also be because the staff do not have knowledge that some people have the need for individual activities (Greenfield et al 1985).
As the body ages altered bones, joints and muscles, which means loss of power, slower movements and gradually worse coordination. These factors often involve an impaired ability to perform certain daily activities which can lead to physical inactivity (Dehlin et al 2000). Tinetti et al (1993) and Rydwik (2008) describes the body's abilities can be positively affected by physical exercise into old age. They also describe how mental health is positively affected by physical activity. Most people who live in residential homes is in the so-called fourth age which is the last phase of life (Laslett 1994, 1996). They often have multiple diseases, have severe disabilities and are in need of care and attention. Andersson (2009) describes the fourth age as the time when you are older and dependent on aid to survive. The boundary between the third and fourth age varies according to the needs of health care that the elderly have and do not follow as much chronological age.
Staff's role in creating opportunities for physical activity
The staff have an important role in need of assistance and help for those who is living in residential homes. If the older persons has major physical problems they need someone who motivates and encourages. It creates an opportunity to be involved in their activities and planning of their daily lives. Staff can also be an obstacle. Is the staff afraid for the patient to fall they often help with everyday activities. By helping it save time too which often is
rendered as a major flaw in the elderly care.
Surveys have been made of how stuff reason about activities (Lundström 2003). The staff felt that the older mainly participated in activities who involved personal care. It was easier to motivate the elderly to be active when the person was just moved. When the person had lived for a while it became more difficult to justify. , prompting staff to musing over what role they had in passivating the elderly. The range of activities in addition to personal care was very limited. The staff lacked knowledge about the interests of older people.
Surveys have been made of how the staff is reasoning about activities (Lundström 2003). The staff felt that the older mainly participated in activities involving personal care. It was easier to motivate the elderly to be active when the person was just moved. When the elder had lived for a while he became more difficult to justify. This meant that staff wondered what role they had in the passivation The staff lacked knowledge about the interests of older people. The staff have an important role in finding out what each individual user has needs and desires. A survey has shown that staff are often the main interlocutor (Karlsson 2006).
There is conflicting research describes where staff describe that the older people are able to decide for themselves how they want their day, when you want to go to bed when you want to shower and how they want to be active. While describing the staff that it was not going to let the older people decide by themselves because there are procedures that must be followed. These procedures often have with the organization to do such as staffing and scheduling (Harnett 2010).
Regardless of who supports the elderly to perform various activities will affect the helper's behavior Sr. ability of activity positively or negatively (Tamm 1999).
The overall aim of my thesis is to study how people in the fourth age, living in residential homes, are willing and have opportunities for physical activity and how the opportunities to be active is affected by the physical environment and the staff behavior.
The aim of this part of the study is to describe variations in perceptions of the concept of physical activity.
A phenomenographic research approach was used to analyze semistructurated interviews with older people and the staff at four residential homes in two different municipalities in Sweden.
Phenomenography is a qualitative research method developed at the Department of Education at the University of Gothenburg. Special features of the method is that it aims to describe different perceptions of a phenomenon. The purpose is not to find out whether some phenomenon is true or false, how many thinks so and so, it is to know how people perceive the phenomenon. The goal is to try to observe a hypothetical range of understanding of a phenomenon. One way to do this is to analyze interviews and compiling various kinds of statements in the categories of description. Relationships between categories of description can then be examined in phenomenography sample space. The process focused on identifying perceptions and examine how perceptions relate to each other. The phenomenografs mean that an idea is something we take for granted. Thus a perception that we do not need to have reflected upon, but as we build our arguments. (Svensson 1984; Marton & Booth 2000).
Totally 30 interviews has been carried out in residential homes. The residential homes have been chose strategically from the perspectives. The residential homes has been statistically choose from the perspectives of large municipality, small municipality, inner city, suburban area and rural. 14 of these interviews have been carried out with older people and the rest of the interviews has been carried out with the stuff in the categories' care staff, head, occupational therapist and physiotherapist. All of the interviewed staff was women.
Among the interviewed elderly were 9 persons women and 5 persons men. Their age had a spread of between 70-95 years, with mean age 87 years. All the people had been living in residential care for more than 6 months.