Understanding Agency in Older Home Care Clients: Resistance and Adaptation

Recent research from the University of Eastern Finland has revealed that older adults receiving home care often view themselves as capable and resilient individuals, despite their need for assistance. This perspective is not always acknowledged by social and healthcare professionals, according to findings published in the Journal of Aging Studies.

The study was part of the broader SOLDEX project, which investigates social exclusion among older adults in home care settings. Researchers conducted interviews with 20 clients aged between 73 and 99 years to explore how these individuals experience and exercise agency in their daily lives. The results highlighted three distinct forms of agency: resistant, adaptive, and supported.

In instances of resistant agency, older individuals exhibit a reluctance to accept the changes that come with their need for help and strive to maintain their previous lifestyle. This can lead to situations where they minimize the number of visits from home care workers, even when assistance is clearly needed.

Adaptive agency, on the other hand, reflects a more accepting attitude towards assistance. Older adults in this category recognize their declining functional capacity and adjust their expectations accordingly. They actively seek to maintain control over their daily lives, often by setting more achievable goals. For instance, they may choose to remain at home rather than venturing out to meet friends, opting instead to connect through phone calls.

Supported agency encompasses those who depend on informal support from friends and family to accomplish significant tasks in their daily routines. Interestingly, this type of agency is often not reliant on home care services but rather on the informal networks surrounding the individuals.

The study underscores that the agency of older adults does not diminish as their need for assistance increases; instead, it evolves and adapts to their changing circumstances. Participants expressed a desire to be recognized as unique individuals with distinct life experiences, values, and aspirations, even as their needs for support grow.

Researchers emphasize the importance of home care professionals recognizing and fostering this sense of agency among their clients. Acknowledging clients' autonomy can enhance the quality of care provided and contribute to a greater sense of control and self-determination for older adults.

This research highlights the need for a shift in how home care services engage with older clients, advocating for a more individualized approach that respects their preferences and promotes their independence.