Background.Participation is considered the main goal of rehabilitation and occupational therapy intervention. This study focuses on older adults' participation in occupations in daily life when receiving home-based rehabilitation.Purpose.To explore how older adults with disabilities participate in daily life subsequent to hospitalization.Methods.A prospective case-orientated design was used, with repeated interviews with three older adults and a constant comparative method of analysis.Findings.Two main categories emerged as the participants' experience of participation: “Continuing to be an agent in daily life” captured the participants' decision making, choosing, and acting in daily life. “Life itself is the agent” identified how the participants, despite their strong wishes to be agents, also could let their participation be directed by their engagement in ongoing daily life.Implications.The findings identified participation as a dynamic engagement ranging from individual agency, including decision-making, choosing, and acting in daily life, to letting life itself be the agent. The emphasis on agency in the participants' experiences challenges rehabilitation professionals to find further means of facilitating the clients' possibilities of being agents in their daily lives.
American Occupational Therapy Association. (2002). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 56, 609–639.
2.
AngusJ., KontosP., DyckI., & McKreeverP. (2005). The personal significance of home: Habitus and the experience of receiving long-term home care. Sociology of Health & Illness, 27, 161–187.
3.
BathenT., & VardebergK. (2001). Test-retest reliability of the Sunnaas ADL Index. Scandinavian Journal of Occupational Therapy, 8, 140–147.
4.
BendzM. (2003). The first year of rehabilitation after stroke – from two perspectives. Scandinavian Journal of Caring Sciences, 17, 215–222.
5.
BorellL., AsabaE., RosenbergL., SchultM-L., & TownsendE. (2006). Exploring experiences of “participation” among individuals living with chronic pain. Scandinavian Journal of Occupational Therapy, 13, 76–85.
6.
BorellL., LiljaM., SvidènG. A., & SaldoG. (2001). Occupations and signs of reduced hope: An explorative study of older adults with functional impairments. American Journal of Occupational Therapy, 55, 311–316.
7.
BorgT. (2003). Livsførelse i hverdagen under rehabilitering. Et socialpsykologisk studie. [Daily life during rehabilitation. A socialphysiological study]. Aarhus: Institut for Sociale forhold og Organisasjon, Aarhus University, Denmark.
8.
BurtonC. R. (2002). Re-thinking stroke rehabilitation: The Corbin and Strauss chronic illness trajectory framework. Journal of Advanced Nursing, 32, 595–602.
9.
Boutin-LesterP., & GibsonW. R. (2002). Patients' perceptions of home health occupational therapy. Australian Occupational Therapy Journal, 49, 146–154.
10.
CardolM., de JongB., & WardC. D. (2002). On autonomy and participation in rehabilitation. Disability and Rehabilitation, 24, 970–974.
11.
CharmazK. (2006). Constructing Grounded Theory. A practical guide through qualitative analysis. London: Sage.
12.
ChristiansenC., & TownsendE. (2004). Introduction to occupation. The art and science of living. Upper Saddle River, NJ: Prentice Hall.
13.
ClaptonJ., & KendallE. (2002). Autonomy and participation in rehabilitation: Time for a new paradigm?Disability and Rehabilitation, 24, 987–991.
14.
DesrosiersJ. (2005). Participation and occupation. Canadian Journal of Occupational Therapy, 72, 195–203.
15.
EilertsenG. (2005). Alt er som før, men ingenting er som det var. Gamle kvinners opplevelser av livet etter hjerneslag. [Everything is as before, but nothing is as before. Daily life after stroke as experienced by older women]. Oslo, Norway: Det medisinske fakultet. Oslo University, Norway.
16.
HammelK. W. (2004). Deviating from the norm: A sceptical interrogation of the classificatory practices of ICF. British Journal of Occupational Therapy, 67, 408–411.
17.
HemmingssonH., & JonssonH. (2005). An occupational perspective on the concepts of participation in the International Classification of Functioning, Disability and Health - some critical remarks. American Journal of Occupational Therapy, 59, 569–576.
18.
HerzogR. A., FranksM. M., HazelM. R., & HolmbergD. (1998). Activities and well-being in older age. Effects of self-concept and educational attainment. Psychology and Aging, 13, 179–185.
19.
HaakM., FängeA., IwarssonS., & Dahlin-IvanoffS. (2007). Home as a signification of independence and autonomy: Experiences among very old Swedish people. Scandinavian Journal of Occupational Therapy, 14, 16–24.
20.
JetteA. M., KeysorJ. J., CosterW., PengshengN., & HaleyS. (2005). Beyond function: Predicting participation in a rehabilitation cohort. Archives of Physical Medicine and Rehabilitation, 86, 2087–2094.
21.
JohannesenA., PetersenJ., & AvlundK. (2004). Satisfaction in everyday life for frail 85-year-old adults: A Danish population study. Scandinavian Journal of Occupational Therapy, 11, 3–11.
22.
JohnsonC. L., & BarerB. M. (2003). Life beyond 85. New York: Prometheus Books.
23.
KielhofnerG. (2002). The Model of Human Occupation: Theory and application. (3rd ed.). Baltimore: Lippincott Williams & Wilkins
24.
KronlöfG. H., & SonnU. (1999). Elderly women's way of relating to assistive devices. Technology & Disability, 10, 161–168.
25.
KrauseN. M. (2000). Role-specific feelings of control and mortality. Psychology and Aging, 15, 617–626.
26.
LaneL. (2000). Client-centred practice: Is it compatible with early discharge hospital-at-home policy?British Journal of Occupational Therapy, 63, 310–315.
27.
LindquistR., & TammM. (1999). Rehabilitation in the home - interplay and conflicts between different parties. Scandinavian Journal of Disability Research, 1, 44–65.
28.
LawM. (2002). Participation in the occupations of everyday life. American Journal of Occupational Therapy, 56, 640–649.
29.
MayerR., & ReidD. (2004). Changes in autonomy and participation in seniors after a stroke: A pilot study. Activities, Adaptation & Aging, 28, 49–70.
30.
MayoN., Wood-DauphineS., CôtèR., DurcanL., & CarltonJ. (2002). Activity, participation, and quality of life 6 months post-stroke. Archives of Physical Medicine and Rehabilitation, 83, 1035–1042.
31.
MirowskyJ. (1995). Age and sense of control. Social Psychology Quarterly, 58, 31–43.
32.
NymanA., & LundM. Larson (2007). Influences of the social environment on engagement in occupations: The experience of persons with rheumatoid arthritis. Scandinavian Journal of Occupational Therapy, 14, 63–72.
33.
NOU No. 2005:8 (2005). Likeverd og tilgjengelighet. Rettslig vern mot diskriminering på grunnlag av nedsatt funksjonsevne. Bedret tilgjengelighet for alle. [Equality and accessibility. Protection against discrimination because of reduced functioning. Ministry of Justice and the Police]. Oslo, Norway: Justis- og politidepartementet.
34.
PattonM. Q. (2002). Designing qualitative studies. In PattonM. Q. (Ed.), Qualitative research and evaluation methods. Thousand Oaks, CA: Sage Publications.
35.
ProotI. M., Abu-SaadH. H., de Esch-JansenW., CrebolderH. F. J. M., & te MeulenR. H. J. (2000). Patient autonomy during rehabilitation: The experiences of stroke patients in nursing homes. International Journal of Nursing Studies, 37, 267–276.
36.
RoweJ. W., & KahnR. L. (1997). Successful aging. The Gerontologist, 3, 433–440.
37.
SatarianoW. A., HaightT. J., & TagerI. B. (2002). Living arrangement and participation in leisure-time physical activities in an older population. Journal of Aging and Health, 14, 427–451.
38.
ShakespeareT. (2006). Disability rights and wrongs. London: Ruthlegde.
39.
St. meld. No. 21. (1998–99). Ansvar og meistring. Mot ein heilskapleg rehabiliteringspolitikk. [Responsibility and coping. Towards a holistic rehabilitation policy]. Oslo, Norway: Det kongelige sosial- og helsedepartement;.
40.
StraussA., & CorbinJ. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks, CA: Sage Publication.
41.
SumsionT. (2004). Pursuing the client's goals really paid off. British Journal of Occupational Therapy, 67, 2–9.
42.
TownsendE. (Ed.). (2002). Enabling occupation: An occupational therapy perspective (2nd ed.). Ottawa, ON: CAOT.
43.
TurnbullJ. C., KerstenP., HabibM., McLellanL., MulleeM. A., & GeorgeS. (2000). Validation of the Frenchay Activities Index in a general population aged 16 years and older. Archives of Physical Medicine and Rehabilitation, 81, 1034–1038.
44.
United Nations General Assembly (1993). United Nations standard rules on the equalization of opportunities for persons with disabilities. Prodeedings of the General Assembly of the United Nations, New York, 1–27.
45.
VikK., LiljaM., & NygårdL. (2007). The influence of the environment on participation subsequent to rehabilitation as experienced by elderly people. Scandinavian Journal of Occupational Therapy, 14, 86–95.
46.
World Health Organization. (2001). International Classification of Functioning, Disability and Health: ICF. Geneva: Author.
47.
WrayS. (2004). What constitutes agency and empowerment for women in late year life. The Sociological Review, 52, 22–38.
48.
WressleE., & SamuelssonK. (2004). Barriers and bridges to client-centered occupational therapy in Sweden. Scandinavian Journal of Occupational Therapy, 11, 12–16.
49.
YinR.K. (2003) Case study research: Design and methods. Thousand Oaks, CA: Sage Publications.
