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Active and non-active agents: residents’ agency in assisted living

Published online by Cambridge University Press:  30 August 2016

JARI PIRHONEN  and
ILKKA PIETILÄ
JARI PIRHONEN*
Affiliation:
School of Health Sciences and Gerontology Research Center, University of Tampere, Finland.
ILKKA PIETILÄ
Affiliation:
School of Health Sciences and Gerontology Research Center, University of Tampere, Finland.
*
Address for correspondence: Jari Pirhonen, School of Health Sciences and Gerontology Research Center, 33014 University of Tampere, Tampere, Finland E-mail: jari.pirhonen@staff.uta.fi
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Abstract

Culturally, institutional care has been seen to strip older people of their status as full adult members of society and turn them into ‘have-nots’ in terms of agency. The substantial emphasis in gerontology of measuring the activity and functional ability of the elderly has unintentionally fostered these stereotypes, as have traditional definitions of agency that emphasise individuals’ choices and capacities. The aim of this paper is to discover what kind of opportunities to feel agentic exist for people who have reduced functional abilities and therefore reside in assisted living. In this paper, agency is approached empirically from the viewpoint of Finnish sheltered housing residents. The data were gathered using participant observation and thematic interviews. This study suggests that even people with substantial declines in their functional abilities may feel more or less agentic depending on their functional and material surroundings and the support they receive from the staff, relatives and other residents. The perception that residents’ agency in assisted living cannot be reduced to measurable activity has methodological implications for gerontological research on agency. Care providers can utilise our findings in reasserting their residents’ quality of life.

Keywords

long-term careethnographyagentic spaceassisted living facilitiesquality of life
Type
Articles
Information
Ageing & Society , Volume 38 , Issue 1 , January 2018 , pp. 19 - 36
Copyright
Copyright © Cambridge University Press 2016 

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References

Agich, G. 2003. Dependence and Autonomy in Old Age. An Ethical Framework for Long-term Care. Cambridge University Press, Cambridge.Google Scholar
Baltes, M. M. and Carstensen, L. L. 1996. The process of successful ageing. Ageing & Society, 16, 4, 397–422.CrossRefGoogle Scholar
Bond, J. and Corner, L. 2001. Researching dementia: are there unique methodological challenges for health services research? Ageing & Society, 21, 1, 95–116.CrossRefGoogle Scholar
Degnen, C. 2007. Minding the gap: the construction of old age and oldness amongst peers. Journal of Aging Studies, 21, 1, 69–80.CrossRefGoogle Scholar
Diamond, T. 1992. Making Gray Gold: Narratives of Nursing Home Care. University of Chicago Press, Chicago.CrossRefGoogle Scholar
Elder, G. H. Jr and Johnson, K. M. 2003. The life course and aging: challenges, lessons, and new directions. In Settersten, R. A. Jr (ed.), Invitation to the Life Course: Towards New Understandings of Later Life. Baywood Publishing Company, Amityville, New York, 49–81.Google Scholar
Eliassen, H. A. 2015. Power relations and health care communication in older adulthood: educating recipients and providers. The Gerontologist. Published online October 21, 2015. doi:10.1093/geront/gnv095.Google Scholar
Emirbayer, M. and Mische, A. 1998. What is agency? American Journal of Sociology, 103, 4, 962–1023.Google Scholar
Featherstone, M. and Hepworth, M. 1989. Ageing and old age: reflections of the postmodern life course. In Bytheway, B., Keil, T., Allat, P. and Bryman, A. (eds), Becoming and Being Old: Sociological Approaches to Later Life. Sage, London, 143–57.Google Scholar
Finlex 1999. Medical Research Act. Available online at https://www.finlex.fi/en/laki/kaannokset/1999/en19990488 [Accessed 25 November 2015].Google Scholar
Freund, A. M. and Baltes, P. B. 1998. Selection, optimization, and compensation as strategies of life management: correlations with subjective indicators of successful aging. Psychology and Aging, 13, 4, 531–43.Google Scholar
Geertz, C. 1973. The Interpretation of Culture. Basic Books, New York.Google Scholar
Giddens, A. 1984. The Constitution of Society. Polity Press, Cambridge.Google Scholar
Gilleard, C. and Higgs, P. 2010. Aging without agency: theorizing the fourth age. Aging & Mental Health, 14, 2, 121–8.Google Scholar
Goffman, E. 1968. Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. Penguin, Harmondsworth, UK.Google Scholar
Golant, S. M. 2003. Conceptualizing time and behavior in environmental gerontology: a pair of old issues deserving new thought. The Gerontologist, 43, 5, 638–48.Google Scholar
Gubrium, J. F. 1997. Living and Dying at Murray Manor. University of Virginia Press, Charlottesville, Virginia.Google Scholar
Holstein, M. B. and Minkler, M. 2003. Self, society, and the ‘new gerontology’. The Gerontologist, 43, 36, 787–96.Google Scholar
Honkasalo, M.-L., Ketokivi, K. and Leppo, A. 2014. Moniselitteinen ja hämärä toimijuus [Ambiquous and vague agency]. Sosiologia, 51, 4, 367–74.Google Scholar
Hsieh, H. F. and Shannon, S. E. 2005. Three approaches to qualitative content analysis. Qualitative Health Research, 15, 9, 1277–88.Google Scholar
Joas, H. 2005. The Creativity of Action. Polity Press, Oxford.Google Scholar
Jolanki, O. H. 2009. Agency in talk about old age and health. Journal of Aging Studies, 23, 4, 215–26.Google Scholar
Katz, S. 2000. Busy bodies: activity, ageing, and the management of everyday life. Journal of Aging Studies, 14, 2, 135–52.CrossRefGoogle Scholar
Kaufman, S. R. 1986. The Ageless Self. Sources of Meaning in Late Life. The University of Wisconsin Press, Madison, Wisconsin.Google Scholar
King, J., Yourman, L., Ahalt, C., Eng, C., Knight, S. J., Pérez-Stable, E. J. and Smith, A. K. 2012. Quality of life in late-life disability: ‘I don't feel bitter because I am in a wheelchair’. Journal of the American Geriatrics Society, 60, 3, 569–76.Google Scholar
Kontos, P. C. 2004. Ethnographic reflections on selfhood, embodiment and Alzheimer's disease. Ageing & Society, 24, 6, 829–49.CrossRefGoogle Scholar
Kontos, P. C. 2005. Embodied selfhood in Alzheimer's disease. Rethinking person-centred care. Dementia, 4, 4, 553–70.Google Scholar
Marshall, V. W. 2005. Agency, events, and structure at the end of the life course. Advances in Life Course Research, 10, 1, 57–91.Google Scholar
Ministry of Social Affairs and Health 2008. National Framework for High-quality Services for Older People. Helsinki University Print, Helsinki.Google Scholar
Morgan, L. A., Eckert, J. K., Piggee, T. and Frankowski, A. C. 2006. Two lives in transition: agency and context for assisted living residents. Journal of Aging Studies, 20, 2, 123–32.CrossRefGoogle Scholar
Nosraty, L., Jylhä, M., Raittila, T. and Lumme-Sandt, K. 2015. Perceptions by the oldest old of successful aging, Vitality 90 + Study. Journal of Aging Studies, 32, 50–58.Google Scholar
Pirhonen, J. and Pietilä, I. 2015. Patient, resident or person: recognition and the continuity of self in long-term care for older people. Journal of Aging Studies, 35, 95–103.Google Scholar
Ritzer, G. 2000. Sociological Theory. McGraw-Hill, Singapore.Google Scholar
Rowe, J. W. and Kahn, R. L. 1997. Successful aging. The Gerontologist, 37, 4, 433–40.CrossRefGoogle ScholarPubMed
Rozanova, J. 2010. Discourse of successful aging in The Globe & Mail: insights from critical gerontology. Journal of Aging Studies, 24, 4, 213–22.CrossRefGoogle Scholar
Schumacher, J. G., Eckert, J. K., Zimmerman, S., Carder, P. and Wright, A. 2005. Physician care in assisted living: a qualitative study. Journal of the American Medical Directors Association, 6, 1, 34–45.Google Scholar
Sewell, W. H. Jr. 1992. A theory of structure: duality, agency, and transformation. American Journal of Sociology, 98, 1, 1–29.Google Scholar
Sherwin, S. and Winsby, M. 2010. A relational perspective on autonomy for older adults residing in nursing homes. Health Expectations, 14, 2, 182–90.Google Scholar
Thurmond, V. A. 2001. The point of triangulation. Journal of Nursing Scholarship, 33, 3, 253–58.Google Scholar
Tulle-Winton, E. 1999. Growing old and resistance: towards a new cultural economy of old age? Ageing & Society, 19, 3, 281–99.Google Scholar
Wray, S. 2004. What constitutes agency and empowerment for women in later life? The Sociological Review, 52, 1, 22–38.Google Scholar
Young, A. J., Ofori-Boateng, T., Rodriguez, K. L. and Plowman, J. L. 2003. Meaning and agency in discussing end-of-life care: a study of elderly veterans’ values and interpretations. Qualitative Health Research, 13, 8, 1039–62.CrossRefGoogle ScholarPubMed