Unfolding familiarity : re-occupying daily life among older persons with physical disabilities, in Japan

Older persons increasingly recover from health conditions within their home and community, as opposed to in hospitals and institutions. In this context, a need has arisen to gain a greater understanding of how they resume their daily occupations to aid their transitions of re-establishing satisfactory daily lives. The overall aim of this thesis was to explore and understand how processes of resuming daily occupation unfold for older persons with physical disabilities, in Japan. Study I: In qualitative retrospective interviews, nine persons were asked to narrate their experiences of resuming everyday activities during hospitalization and after returning home. The constant-comparative analysis’ resulted in exposing three themes that expressed, how the participants spend and generated vigor, how they reconciled to requiring assistance, and that they had acted upon moral quests of doing what was the right thing to do (for themselves and for other persons). Study II consisted of participant-observation of daily occupations and complementary interviews with five participants. The aim was to identify meanings given to the actions of participants and other persons involved in observed situations. Through a narrative analysis these meanings were identified as consisting of three complementary strategies. Two of the three strategies aimed to mitigate given problems, one by ‘acting on a plan to achieve one’s goals’, the other by ‘taking a step in a preferred direction by capitalizing on emerging opportunities’. The third strategy focused on avoiding undesirable experiences by ‘modifying problematic situations’. Persons used these approaches flexibly in responding to shifts that mattered in the observed situations and according to their skills, resources and perspectives. Study III was a 9-month longitudinal study of four participants with physical impairments. The aim was to explore and understand how their engaging in daily occupations unfolded over time. Data included qualitative interviews and observations. The findings showed the striving for repertoires of occupations that created familiarity in terms of fulfilling their occupational needs and meanings. Familiarity was also experienced when participants engaged in occupations in line with their expectations. Equally, familiarity was a quality that often assisted participants to deal with ambiguities and challenges in daily life situations. Familiarity unfolded as it was created and adjusted to evolving daily lif