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Interview: A Day to Be Lived

 

Dr. Catharina Nord

Dr. Catharina Nord


They have said good-bye to their homes, given away many of their cherished possessions and moved into assisted living.

Swedish architect and researcher Catharina Nord examined how older adults handle the loss of many belongings when they move into assisted living, and how they decide what to bring with them.

What she found surprised her.

Dr. Nord is senior lecturer at the National Institute for the Study of Ageing and Later Life at Linköping University, Norrköping, Sweden.

The findings appeared online in the Journal of Aging Studies (Vol. 27. No. 2, 2013).

AHB reached Dr. Nord at Linköping University.

Ruth Dempsey: How is assisted living structured in Sweden?

Catharina Nord: Assisted living is form of housing that is reserved for people who require 24-hour care. The housing is funded by the local municipalities, and an individual who applies for residency is assessed by local social services.

In fact, very few people in Sweden live in assisted living.

The facility is often organized in wards with 10 to 15 people living together. Individuals have their own small flat and access to common areas like the dining room and living-room.

RD: Participants were coping with various medical conditions.

CN: Most of the older persons had mobility problems for various reasons, such as stroke, and were using walking aids or a wheelchair. Others were frail and had poor balance as a result of advanced age. A few had vision impairments.

RD: So what were their new living spaces like?

CN: They were very small. The most common living unit was a one bed-sitting room with a kitchenette and a bathroom. Some had a bed-sitting room and a small kitchen. These bigger flats also had a balcony, which must have been very nice in the summer, especially for those who could not go out on their own.

RD: The study showed most participants brought at least one item from their original home.

CN: Yes, this was usually a large item, such as a chair or chest of drawers. Quite often, it had been made by their father. These objects were among the oldest artifacts they had and more than hundred years old, in some cases.

RD: There were other objects which you dub memorabilia. Can you give me an example?

CN: Actually, the items just mentioned, from their parental home, are typical memorabilia.

Other common things were photos, mainly studio photos of generations of family members, taken over nearly a century. For example, a parent’s wedding photo.

One woman had a photo of herself and her deceased sister when they were five. It was an 85-year-old photo.

Another had a small, decorative frog her little son had bought when he wanted to make peace after an argument with his mother.

And many had brought small things reminding them of their roles throughout life. These could be gifts from workmates or paintings won in the union’s art club lottery.

RD: There were also reminders of cherished hobbies and pastimes.

CN: These objects closely mirrored male and female leisure activities. For example, men had sports awards or wooden handmade things. Women had kept small decorative hand embroideries or knitted items.

Most of them had stopped doing this kind of work because of problems with their hands. But one woman, the youngest in the study, still knitted children’s outfits for the local Red Cross.

RD: The old people chose a practical item, when you asked them to indicate their most important possession. Why is that?

CN: This was a surprise. In similar studies, older adults had identified memorabilia as most important.

In my study, the participants seemed less focused on the past and more concerned with the quality of everyday life. For instance, they mentioned their TV set, their bed or their new table where they sat for a large part of the day.

RD: You say participants used these practical items to anchor their everyday activities. How so?

CN: These old persons had organized a way of living that took into account their restricted mobility and which suited their interests.

The participants shifted during the day between a few spots in the bed-sitting room. For example, some had a table where they kept things they needed within reach, such as magnifying glass, a basket of fruit, a roll of kitchen paper, a radio, a mobile phone or other practical things for entertainment. One 90-year-old man dubbed this table "his office."

Others had a comfortable armchair where they could sit and watch TV and read books or newspapers.

And they all had a coffee machine, which they sometimes used to serve coffee for guests.

RD: They had their meals in the dining room, but they chose to spend most of the time in their apartments.

CN: This is an important point. I have met other people in research projects who have said the same. Many who live in assisted living find their privacy very important. They want to be able to choose whether they take part in joint activities or not.

Some are too fragile to socialize much with strangers or new friends. They have to use their energy economically.

Also, one man mentioned that hearing impairments and cognitive difficulties can hamper conversations with fellow residents, and he regretted that.

I don’t think the staff would force anyone to join an activity if they did not want to participate.

RD: These old persons played down their aches and pains and seized the day.

CN: Yes. It seemed to me that the people I met in this study lived a very dignified and peaceful life. They were pleased with their new home. They were free from obligations and could choose to do what they wanted within certain limits.

They challenged the image of older people as depressed and passive in a way I did not expect. I think the study showed that it is possible to be independent, even in a situation in which you are highly dependent on staff to manage ordinary daily activities.

However, I have to add that I met people who were in very good shape. I would guess that there were people in the assisted living facility who were less able to manage.