Abstract
In many high-income countries rising longevity supports predictions that the proportions of older people in populations will continue to grow. As people age, they are more likely to experience poor health and/or disability. This, together with the dynamics of supportive care arrangements, has implications for where older people live and how well their lives go.
In Scotland, approximately, 90% of those aged 65 years and over currently live in a domestic home, 6% in sheltered housing (which provides some care or support) and 4% in residential care (which provides higher levels of care, sometimes including nursing). Housing, health and social care policy in the UK, including Scotland, has emphasised the value of ageing in place in domestic settings. However, some older people do not and perhaps cannot live in domestic settings, and alternatives might have some advantages for their wellbeing. We were interested in exploring how changes in residence might shape and be shaped by the valued capabilities of older people.
The overall aim of the study was to examine the relationships between place and wellbeing among older people. We drew upon Sen’s capability approach and adopted a qualitative approach, underpinned by a constructionist mode of inquiry.
In-depth interviews were carried out with 26 participants aged between 65 to 96 years who were living in a range of domestic, sheltered and residential care settings sampled from more and less affluent areas of Dundee, Scotland. The interviews were conducted in a conversational style, taking account of the cognitive and conversational capacities of the individuals involved. Interviews were supported by the use of a topic guide. They incorporated a biographical perspective and explored both the kinds of things that people considered important for their wellbeing and the various ways that the places they lived in could impact on those. The interviews were audio recorded and transcribed. A thematic analysis was carried out using the Framework approach.
This paper focuses on older people’s reasons for and experiences of moving home from domestic to either other domestic or sheltered or residential care settings. Informed by relationally theorized notions of ‘capabilities’ and ‘place’, we worked with an explicit recognition that relocation was an on-going, complex, and dynamic process. Our qualitative approach usefully allowed us to consider each person within his/her context and to generate thick informational descriptions. The biographical perspective allowed us to appreciate each person’s past as well as more current experiences and future-oriented considerations.
Key findings include:
1) Moving from one home setting to another can be a way to secure and stabilize some valued capabilities. However, moving from one place to another might also involve a trade-off between valued capabilities.
2) Peoples’ options for relocation, such as, deciding where to relocate to (i.e., to a particular setting, or a particular locality, or a city) and (or) effecting a decision to relocate might be more or less restricted and for a variety of reasons. For example, some kinds of health impairments might limit the options an older person has to decide to move from a domestic into another domestic or a sheltered setting.
3) Change in place of residence can have a number of positive and negative implications for people’s capabilities. Whether capabilities are positively or negatively influenced depends upon the interplay of a range of individual (e.g., valued goals and identities, health impairments, participation in the relocation process, socio-economic contexts) and socio-spatial factors (e.g., material and social features of place, access to support from others).
4) It may not always be possible to anticipate all the changes in capabilities that relocation may bring. Our data includes several examples of both positive and negative capability changes that people had recognised only after living in their new place of residence for a while.
Our findings confirm some important advantages of exploring experiences of change in place of residence using relational notions of capabilities and place and that can be useful in making informed interventions about how to support older people.
In Scotland, approximately, 90% of those aged 65 years and over currently live in a domestic home, 6% in sheltered housing (which provides some care or support) and 4% in residential care (which provides higher levels of care, sometimes including nursing). Housing, health and social care policy in the UK, including Scotland, has emphasised the value of ageing in place in domestic settings. However, some older people do not and perhaps cannot live in domestic settings, and alternatives might have some advantages for their wellbeing. We were interested in exploring how changes in residence might shape and be shaped by the valued capabilities of older people.
The overall aim of the study was to examine the relationships between place and wellbeing among older people. We drew upon Sen’s capability approach and adopted a qualitative approach, underpinned by a constructionist mode of inquiry.
In-depth interviews were carried out with 26 participants aged between 65 to 96 years who were living in a range of domestic, sheltered and residential care settings sampled from more and less affluent areas of Dundee, Scotland. The interviews were conducted in a conversational style, taking account of the cognitive and conversational capacities of the individuals involved. Interviews were supported by the use of a topic guide. They incorporated a biographical perspective and explored both the kinds of things that people considered important for their wellbeing and the various ways that the places they lived in could impact on those. The interviews were audio recorded and transcribed. A thematic analysis was carried out using the Framework approach.
This paper focuses on older people’s reasons for and experiences of moving home from domestic to either other domestic or sheltered or residential care settings. Informed by relationally theorized notions of ‘capabilities’ and ‘place’, we worked with an explicit recognition that relocation was an on-going, complex, and dynamic process. Our qualitative approach usefully allowed us to consider each person within his/her context and to generate thick informational descriptions. The biographical perspective allowed us to appreciate each person’s past as well as more current experiences and future-oriented considerations.
Key findings include:
1) Moving from one home setting to another can be a way to secure and stabilize some valued capabilities. However, moving from one place to another might also involve a trade-off between valued capabilities.
2) Peoples’ options for relocation, such as, deciding where to relocate to (i.e., to a particular setting, or a particular locality, or a city) and (or) effecting a decision to relocate might be more or less restricted and for a variety of reasons. For example, some kinds of health impairments might limit the options an older person has to decide to move from a domestic into another domestic or a sheltered setting.
3) Change in place of residence can have a number of positive and negative implications for people’s capabilities. Whether capabilities are positively or negatively influenced depends upon the interplay of a range of individual (e.g., valued goals and identities, health impairments, participation in the relocation process, socio-economic contexts) and socio-spatial factors (e.g., material and social features of place, access to support from others).
4) It may not always be possible to anticipate all the changes in capabilities that relocation may bring. Our data includes several examples of both positive and negative capability changes that people had recognised only after living in their new place of residence for a while.
Our findings confirm some important advantages of exploring experiences of change in place of residence using relational notions of capabilities and place and that can be useful in making informed interventions about how to support older people.
Original language | English |
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Publication status | Unpublished - 12 Sept 2015 |
Event | 2015 HDCA Conference: “Capabilities on the Move: Mobility and Aspirations” - Georgetown University, Washington DC, United States Duration: 10 Sept 2015 → 13 Sept 2015 https://hd-ca.org/conferences/ |
Conference
Conference | 2015 HDCA Conference: “Capabilities on the Move: Mobility and Aspirations” |
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Country/Territory | United States |
City | Washington DC |
Period | 10/09/15 → 13/09/15 |
Internet address |
Keywords
- Older people
- Residential relocation
- Domestic
- Sheltered and residential care homes