Negotiating occupation: How older people make sense of the concept of “occupation”

ABSTRACT

Background: The concept of occupation has been widely discussed and developed theoretically in occupational science and occupational therapy.

Objectives: To explore how older community living adults themselves describe and negotiate the meaning and definition of “occupation”.

Methods: Twenty-seven persons in northern Sweden (67-95 years old) participated in workshops with audio-recorded discussions. The transcribed discussions were analyzed using discourse theory.

Findings: Discussions started with efforts to establish a initial definition of occupation focusing on what kinds of practices could be seen as occupations. Second, there were significant efforts to value and grade different occupations, described as evaluative definitions. Last, participants resonated around the disadvantages of stable definitions of occupations, and put forth reflexive arguments for more relativizing definitions.

Conclusion: While physical occupations were tellable, social and mental occupations seemed to require a language that was less familiar. Therefore, interventions that suggest participants to engage in social or mental occupations need to provide a language that makes non-physical occupations comprehensible as occupations.

背景：生活活动概念已在生活活动科学和活动治疗中得到了广泛讨论，其理论也得以发展。

目标：探讨老年社区居民自己如何描述和讨论“生活活动”的含义和定义。

方法：瑞典北部（67-95岁）的27位老人参加了研讨会，并进行了录音讨论。使用话语理论分析了转录的讨论。

结果：讨论之初建立了生活活动的初始定义，重点是确定可以将哪种行为视为生活活动。其次，努力评估和将不同生活活动分级，将其描述为评价性定义。最后，关于稳定的生活活动定义的弊端，参与者大加评论，并提出了反身论点，要求定义更加相对化。

结论：尽管身体型生活活动是易用语言表述的，但社会和精神生活活动似乎需要一种不太熟悉的语言。因此，如果建议参与者从事社会或精神生活活动，这种干预措施需要提供一种语言，使非身体性生活活动可被理解为生活活动。

Antecedentes: El concepto de ocupación ha sido ampliamente discutido y desarrollado teóricamente en la ciencia ocupacional y la terapia ocupacional.

Objetivos: Estudiar cómo los adultos mayores que viven en residencias comunitarias describen y negocian el significado y la definición de “ocupación”.

Métodos: Veintisiete personas (67-95 años) del norte de Suecia participaron en talleres en los que se realizaron discusiones que fueron audiograbadas. Las discusiones, posteriormente transcritas, fueron analizadas usando la teoría del discurso.

Hallazgos: Las discusiones comenzaron realizando intentos para establecer una definición inicial de la ocupación, centrándose en qué tipos de prácticas podrían considerarse como ocupaciones. En segundo lugar, se efectuaron esfuerzos significativos para valorar y calificar diferentes ocupaciones, descritas como definiciones evaluativas. Por último, los participantes opinaron sobre las desventajas que conllevan las definiciones estables sobre las ocupaciones y presentaron argumentos reflexivos para relativizarlas.

Conclusión: Si bien las ocupaciones físicas pudieron ser relatadas fácilmente, las ocupaciones sociales y mentales parecieron requerir el uso de un lenguaje menos familiar. Por lo tanto, las intervenciones que sugieren a los participantes dedicarse a ocupaciones sociales o mentales deben acompañarse de un lenguaje que haga que las ocupaciones no físicas sean comprendidas como ocupaciones.

KEYWORDS:

• Occupational science
• Older adult
• Terminology
• Discourse analysis

How to understand the concept of occupation has been widely discussed in occupational science and occupational therapy (Hocking, 2009). The conceptualization of occupation is a central construction to the science and profession, thus continuous debates and negotiations are immensely relevant. While the complexity of the concept has attracted much research (Bunting, 2016), the complexity of occupation can also make communication more difficult. For example, there is a lack of clarity on how to organize and categorize the concept (Aldrich, McCarty, Boyd, Bunch, & Balentine, 2014; Hammell, 2009a, 2009b) and on its relation to the equally central concept of activity (Hinojosa, Kramer, & Brasic Royeen, 2017). Further, the fluctuating uses of the different terms over time make consistent definitions difficult (Bauerschmidt & Nelson, 2011).

Organization and classification of occupation has varied over time within occupational therapy and occupational science. From the inception of the profession in the 1920s, Meyer (1922/1977) described a typological categorization of “The Big 4”: work, play, rest and sleep. Since then, occupational therapy associations and theory developers have refined and advanced the notion of the Big 4 by constantly adding or withdrawing categories (e.g., American Occupational Therapy Association, 2017; Townsend & Polatajko, 2007). Today, personal meaningfulness and purposefulness are increasingly included as critical characteristics of occupation, revealing assumptions of a natural variation between individuals (Nelson, 1996). However, the ambition to classify occupations into fixed and labelled groups is still strong, and the pursuit of finding all-embracing and definite categorizations has not been thoroughly problematized until of late. For example, Jonsson (2008) argued in favor of experiential rather than typological categories, and emphasized that categories are and should be in constant flux. Hammell (2009a, 2009b) and Aldrich et al. (2014) further criticized the failure of established categories to capture lived experience, and being excluding and potentially enhancing injustices.

Recently, the focus on occupations related to older adults has often been associated with the concepts of ‘active’ and ‘successful’ aging, both of which may partly be seen as policy responses to the challenges of population ageing. Both concepts destabilize the view on old age as a period of decline and open up a view of older people as possibly active (Barrett & McGoldrick, 2013). The concepts have, however, met with critique for prioritizing societal and political needs before the needs of people (Jonsson, 2008) and for the way the concepts normalize practices that still remain unattainable for many (old-old) due to severe illnesses or disabilities (Foster & Walker, 2015; Holstein & Minkler, 2003; Yin, 2010). The idealization of active aging creates tensions for all, both for “those unable to work towards them and for those who can engage in ‘responsible’ practices of the self” (Laliberte Rudman, 2006, p. 196). Further, there is a moral aspect permeating the active ageing discourse (de Falco, 2016), as the opposites of being active—such as idleness and dependency—are often regarded as inferior.

Hocking’s (2009) concept of occupation influenced our approach. She defined occupation as the “knowledge people have about the things people do” (p. 142). This implies an emic perspective focused on the notions people themselves have about what constitutes occupation. The emic perspective aims to capture the meaning of real-world events (Yin, 2010) from the insider’s perspective, or, in the words of Willis (2007), “through the eyes of members of the culture being studied” (p. 100). As such notions are culturally invested and dependent (Bonder, Martin, & Miracle, 2004), it can be presumed that valued occupations might differ between contexts. This study contributes knowledge about how older people in the context of northern Scandinavia make sense of the concept of occupation. Exploring the concept of occupation within specific contexts is important to avoid misunderstandings as the term is used both generally in society and in the specific contexts of occupational science and occupational therapy (Müllersdorf & Ivarsson, 2011). Inspired by Gubrium and Wallace’s article “Who theorizes age?” (1990), we argue that lay people’s own theorizing about occupation gives important insights into emic notions of occupation, which also can include understandings of aging, being active, and becoming frail (see for example Foster & Walker, 2015). A deepened understanding of older adults’ notions of occupation may provide occupational theorists and therapists with enriched understandings of how people might think about and understand occupation, which may in turn have consequences for how they respond to occupation-based interventions.

We approached the question of emic understandings of occupation through discourse analysis of older people’s discussions amongst each other, as this has not previously been given much attention. The aim of this study was therefore to explore how older community living adults describe and negotiate the meaning and definition of “occupation”. This is important because Butler (1995) argued that an important task for research is to study what different understandings and theorizations authorize and what they exclude or foreclose (p. 39). Our goal was to shed light on: a) older people’s discursive construction of the concept of occupation, b) how their construction was situated in context (Prodinger, Laliberte Rudman, & Shaw, 2015) in the sense that it was conditioned by and imbued with normative discourses, and c) what positions were made available and unavailable to older people through these very constructions. The study contributes to occupational science and occupational therapy by studying emic constructions of a concept that has become increasingly central in research about aging.

Methods and Material

This study is a part of a collaborative project “Exploring occupation” between Umeå University, Sweden and Colorado State University, USA and was approved by the local ethical committee at Umeå University (Dnr: 2015/339-31Ö). The study’s focus on descriptions and negotiations of the concept of occupation meant that we needed to construct situations where such descriptions and negotiations would occur. The workshop form was therefore considered a methodological advantage.

Material and procedure

Researchers collected material through 2-hour workshops conducted in Swedish with people who were over 65 years of age. Workshops, a creative and practical participatory method, were employed to produce and collect reliable and valid data. Participatory methods often combine practical tasks with verbal discussions (Ørngren & Levinsen, 2017).

We employed a convenience sampling method to identify participants. To obtain a diverse example, we distributed invitations to participate through a variety of means such as social media, e-mail lists, advertisements, and personal contacts at local social meeting places. Interested persons contacted the project leader (last author) through e-mail or phone to learn more about the study.

Twenty-seven persons, between 67 and 95 years old, contacted the project leader and chose to participate. All participants met the inclusion criteria of living in the community in an urban area in northern Sweden. A majority were women (21 out of 27 persons). All participants had at least 11 years education; many had as much as 20 years of education. Sixteen of the participants rated their health as very good or excellent in a demographic form, no one rated their health as bad. Six persons reported health problems that influenced their everyday occupations. The number of participants and the selection meant that there was a bias towards women and middle class experiences.¹ Our aim was, however, not to offer a generalizable image of how older people define occupation once and for all, but rather we wanted to shed light on the discussions and negotiations through which such definitions are produced. The workshop form was therefore chosen despite the possible limitation that social dynamics or pressure may hinder people from taking up delicate subjects or from arguing in favor of a certain view (Bryman, 2008).

Participants were placed into three groups based on their availability to meet. Each of the three groups had between 8 and 11 participants (see Table 1) and they met twice (about 4 hours in total). Therefore, in total, six audio-taped workshops with almost 12 hours of discussion transcribed verbatim constitute the data for the study.

Table 1. Participants in the three groups

Group	n	Age span	Women/Men (n)	Living alone (n)
I	8	68-95	5/3	4
II	11	70-81	9/2	9
III	8	67-78	7/1	4

Prior to the start of the first workshop, each participant consented and completed the demographic and basic health form. The first task required participants to write down, on sticky notes provided, examples of occupations they thought people engage in on an everyday basis. Following completion of the task, participants were divided into smaller groups and asked to share their ideas of occupations with members of the small group. Next, they discussed, similarities and differences among their ideas of occupations. Participants were then encouraged to begin to group occupations together to create a preliminary categorization.

In Swedish, the concept occupation is often translated interchangeably into either activity or meaningful activity (Swedish: aktivitet or meningsfull aktivitet) (Fisher, 2009; Fisher & Nyman, 2007; Müllersdorf & Ivarsson, 2011). In the instructions to the workshops, we therefore used the Swedish expression meaningful activity. No discussions or theoretical understandings about the concept occupation were introduced to the participants. However, given that the participants knew that the research project was connected to the field of occupational science and therapy, and that they were invited because of their age, it is likely that they had notions of occupational therapy and aging in mind when interpreting ‘meaningful activity’.

The second workshop was held within one week’s time from the first workshop. Participants met in the same small groups to refamiliarize themselves with materials from the first workshop, and complete a single categorization of occupation. Next, each small group presented their suggestions to the whole group. Finally, the whole group discussed how the different categorizations presented by the small groups could be adapted or modified to create one shared view of categorizations of occupation.

The project leader introduced the workshop aim and gave instructions for each task, but did not participate in any of the small or large group discussions. All group discussions were audio recorded, resulting in almost 12 hours of discussions. All audiotapes were transcribed verbatim. Quality indicators for the workshop methodology comprise open discussion questions that do not contain too much information and minimize interference by the research project participants. Detailed descriptions of the workshops are provided in Appendix A.

Data analysis

We approached the material as ongoing constructions of occupation. Aiming to study the sense-making around the concept, we chose the analytical approach of discourse theory (Laclau & Mouffe, 1985). The analysis primarily aimed at identifying the articulations of signs that together formed discourses of occupation, i.e., how different suggested occupations were connected or disconnected as the participants discussed, and how these were in turn linked to valuations. Analysis included implied searching for the concrete ways in which the participants constructed the concept of occupation. For example, we searched for ways to signify occupation that were not questioned within the groups, but were rather accepted as neutral (Howarth, 2010).

In addition, we identified what was excluded from the possibility of being understood as occupations—doings or practices that were defined by the participants as non-occupations. Such excluded doings mark the limits of discourse and work to create homogeneity within it. In their study of the situated nature of human occupation, Prodinger et al. (2015) noted how excluded doings often become so impossible to subsume within a discourse that they become unthinkable as examples of occupation. But since discourses are always constituted in relation to their discursive exterior or discursive outside defined as not belonging to the discourse, but which is still a prerequisite for its constitution (Laclau, 1990), the field of excluded doings always risk destabilizing the discourse.

In the analysis, we studied the participants’ struggle to define certain doings as either excluded or included in a discourse of occupation. We refer to this struggle as negotiations as the participants did not always agree about how to understand and define different doings. In the negotiations, some doings seemed specifically floating in character, in the sense that they were open for various and sometimes contradictory inscriptions; they seemed “incapable of being wholly articulated to a discursive chain” (Laclau & Mouffe, 1985, p. 113). The same doing could be articulated in such a way that it became included as an occupation, but it could also be articulated so that it was excluded from the possibilities of being comprehended as occupation.

All transcribed data were read several times by the two Swedish-speaking authors to get an overall view of the material. In a first step, we analyzed each transcript in relation to questions about the specific words, phrases and arguments used to define and value different occupations. Inspired by Laliberte Rudman (2010), we also noted how the various ways of comprehending occupation were connected to normative subjectivities, or subject positions, that discourses designate for people to take. For example, a discourse of education offers ‘pupil’ and ‘teacher’ as important subject positions, while a discourse of healthcare offers subject positions of ‘client’, ‘doctor’, ‘nurse’ and so on. Studying occupational possibilities, Laliberte Rudman (2010) emphasized that power operates precisely through the shaping and promoting of possibilities for subjectivity. In that sense, discourses set the limits of comprehensible behavior.

We then described the dominant traces in the studied workshops, focusing on the main ways in which the participants negotiated and finally arrived at an understanding of occupation that they could agree on. Quotes that represented the participants’ process were chosen, translated into English, and language checked by a professional translator. This was a back-and-forth phase in the analysis that was mixed with discussions in the group of authors to check, confirm, and elaborate patterns. The analytic feedback by all co-authors aimed to enhance credibility and transparency. In a second step, and accounted for in the discussion section, we viewed the negotiations for how they related to, and were structured by, more overarching societal discourses that influenced the negotiated discourse of occupation and worked to privilege certain subject positions for older people. For empirical examples of statements that constituted and formed the discourses, see Table 2.

Table 2. Empirical examples of statements that constituted the types of definitions that formed the discourse of occupation within the studied workshops

Initial definition (Statements that established some doings (primarily physical occupation) as a non-negotiable activities and others as non-activities)	Evaluative definitions (Statements that assessed the level of engagement or the reasons to engage in an occupation, finding some doings to be too ordinary to qualify as activities)	Relativizing definitions (Statements that accounted for the subject who was supposed to perform the occupations, and suggested a need to understand occupation in relation to that subject’s prerequisites)
Well, I thought occupation, then you do something, and when you do something then you work with your body (18:630-631).	It depends on how much you cry, if it’s a physical occupation or a (laughter) social occupation (13:441).	“occupation is dependent on your possibilities” (19: 670).
Just standing … I mean, then you just stand and think. You don’t do anything. And then someone says: What are you standing here for, you have to do something (91:3191-3192)	… all those bad habits … chewing gum, babbling, being careless, being unfocused (144:5057-5058).	[What constitutes occupation is] dependent on what kind of person you are. (19:662-663).
– It’s easier to define physical [occupation] I must say … […] – Yes, physical occupation is more apparent in a way. – Yes, it [physical occupation] is easier to define (108:3786-3790).	– [The sticky note with] drinking wine you’ll have to put here. – Exactly. – It’ll go with the vices (141:4933-4935).	[as you age], then you’ll do other things, you adapt life after what you can do (20:690-691).
– Training, that must be a physical occupation. – A very physical occupation (laughter) (28:996-997).	Then there are other activities that you do just to survive, they feel like they are of lower standing […] and then they might not be, I mean, an occupation (20:708-711).	What you don’t see as an occupation today might become an occupation [with time] (21:736-737).
I have a suggestion, let’s start with a category that is simple […], I suggest physical occupation, because that is nothing to discuss (67:2356-2359).		… for an older person also dusting might be straining (44:1531).

The team of researchers was active within the field of aging and gerontology, but had their backgrounds in different disciplines – occupational science, occupational therapy, and ethnology. This meant that different but not opposing perspectives were brought into the analysis; the ethnologist brought a focus on identification, discourse, and power, and the occupational scientists brought perspectives that situated the material in occupational therapy theory and practice. To enhance the rigor of the analysis we applied analyst triangulation, reflexively discussing different possibilities to understanding the material.

Findings

In the following, we account for the process of forming a discourse of occupation that was present in all groups. The process included negotiations about how to properly understand and define occupation as a concept. Because each participant individually wrote down examples of occupations they thought people, in general, engage in on an everyday basis, the workshop discussions began with the different occupations each participant identified. To begin, participants were not always in agreement with what were considered occupations. To reach consensus, participants engaged in vivid negotiations of what were and were not occupations and how occupations should be defined. However, all discussions resulted in three different ways of thinking about and defining occupation. First, they involved efforts to establish an initial definition of occupation that focused on what doings that could be seen as occupations. Second, and in an attempt to nuance the initial definition, there were significant efforts to value and grade different occupations, which we describe as evaluative definitions. Last, there were also efforts to come together around the disadvantages of stable definitions of occupations, and reflexive arguments for more relativizing definitions. Highlighting these three types of definitions—and the negotiations that led to them—sheds light on ideas of occupation that were taken for granted and on values that were important to the participants. A table showing examples of statements that formed the three discourses is presented in Table 2.

Initial definition: Dominant and taken-for-granted notions of occupation

All groups started their discussions with references to doings that they instantly recognized as occupations. For all groups this entailed doings that were in some sense physical, involved effort, and were detached from everyday routine occupations. Physical doings, specifically doings that were possible to identify as physical exercise, were described as typical or self-evident occupations, and were seldom discussed or questioned. Rather, they were described as “a must for body and soul”: “I have a suggestion, let’s start with a category that is simple … , I suggest physical doing, because that is nothing to discuss” (67:2356-2359). The fact that Swedish physicians (GPs) prescribe physical activity was taken as proof that this definition was highly relevant; revealing the impact that medical science and medical professions had on the participants and reinforced a bio-medical focus on the physical body.

While physical exercise had a self-evident position as occupation, other doings were not as easily defined. In their discussions about what occupation is, the participants also struggled to establish the limits of occupation. Passivity, together with everyday routine doings that require next to no effort, were recurrently dismissed as occupations altogether and were consigned to the initial discourse’s constitutive outside. In this way, doings that were defined as absolute passivity, such as resting, breathing, and sleeping, were mostly found impossible to articulate with occupation.

However, the participants frequently engaged in debates about doings that were at first positioned as non-occupation, or passivity. Some participants made great efforts to rescue, as it were, such doings from being dismissed as non-occupations. While the participants’ reasoning sometimes meant that only quite strenuous physical exercises were articulated as occupations, another extreme of their line of thinking was the argument that almost everything could be articulated with occupation: “To not be brain dead … that’s occupation!”

As small group discussions continued, most realized that physicality did not sufficiently cover all doings that the participants perceived to be occupations. Just like scholarly and professional efforts to define the concept, the participants tried different solutions with additional categories that complemented physical doing. All groups classified occupations into subgroups labeled with words like physical, social, and mental occupations. The more participants thought about the context of different doings, the more difficult it became to classify doings in only one category. For example, physical exercise at a gym could be seen as “physical” but also as “social” if it was a group exercise. Occupations related to sexual life seemed to have a specifically floating character, constituting a surface open for various impressions. Some wanted to organize sex according to its physical character while others disagreed and wanted to define it as a mental or a creative occupation.

Despite the engaged efforts to extend their group’s list of categories, most groups ended up with examples of occupations that were difficult to fit into the categories they had decided on. Furthermore, it did not suffice to include doings just because they qualified into a classification, but that there was also a need to consider the level of engagement as well as the reasons for engaging in an occupation.

Evaluative definitions: Focusing on quantities, intensity and reasons

In an effort to include doings that were not considered “obvious” occupations, the participants formulated ways to consider the performance of a doing. Two axes appeared in the discussions. On one axis, participants focused on grading dimensions of quantity and intensity in the doing (a dimension of more or less), and on the other they graded the reasons to go about a certain doing (a dimension of duty or pleasure).

A matter of more or less

In grading quantity and intensity, the participants compared different doings and argued that some doings involve high awareness and effort, such as physical exercise. Other doings, they argued, require less intensity, e.g. putting on the dishwasher, described as done automatically and with no real effort.

The dimension of more or less did not always include physical engagement but could also be about mental or emotional engagement. Crying was an example where one could cry with less engagement, or be involved in hysterical crying. Swimming was another given, where bathing in one’s own bath tub was considered less engaging than taking a bath with your grandchildren in a public pool. The latter involved transportation and responsibility for the children and was more physical and strenuous, and thus more of an occupation.

The discussions about whether a doing was more or less of an occupation were not neutral. Rather, they constituted morally charged debates that valued doings in terms of good and bad. Doings that could be defined as more of an occupation were decidedly rated as better than doings that were defined as less of an occupation. Some of the doings that were negatively charged were discussed in relation to expressions like “bad habits” or “bad behavior”. The bad habits and behaviors were exemplified with doings like chewing gum, being a slattern, being distracted, drinking wine or chattering, and were unlikely to become defined as proper occupations.

The discussions of occupations that were defined as less of an occupation further tended to rub off on the individuals who performed them; the risk of guilt by association sometimes made the participants reassure each other that it was only an example, nothing they did themselves. In this sense, there were undoubtedly connections between suggested occupations and the performing subject. This was often indirectly communicated through descriptions where participants took themselves as examples. Countering any suspicions that early retirement would imply that she was an inactive person, one woman emphasized that “I’ve never just sat and looked through the window and felt sorry for myself for not being well, but I’ve found my way to do things”.

Interestingly, discussions about devalued occupations that the participants were themselves engaged in were often accompanied by laughter. Such laughter worked to upgrade the otherwise devalued behaviors; devalued occupations were rearticulated as the positively charged privilege of certain positions, as when the participants argued for their right as retirees not to be active or their deliberate choice to not to care much about the everyday chores.

A matter of having to or having fun

Occupations were further valued based on the reasons they were carried out. Doings described as done out of necessity were separated from doings described as fun and rewarding, and were also explicitly described as “inferior” or of “lower standing”. The devalued doings such as cooking could potentially be seen as occupations, but it was clear that they were not highly valued.

Interestingly, the gap between having to and having fun could also be used to characterize the participants themselves and it was often used in self-presentations through expressions like “If I agree to something it’s because I find it nice and fun”. A similar effort to explicitly establish the participants’ identities was evident in the quotation below:

W1: We are the kind that are mostly engaged in social activities and pleasure and physical activities, but these ‘have to’s’ and everyday things they have less meaning in our lives … You can all see that, can’t you?

W2: Yes.

W3: That’s positive!

The women agreed on a self-understanding as being more into having fun than having to, and also that this was a good thing.

However, the participants also highlighted that whether an occupation was a have-to-do thing or not was partly in the eye of the beholder. What constituted “fun” or “duty” was therefore not always agreed on. For example, vacuuming cleaning was primarily seen as a boring everyday chore and thus scored quite low as an occupation. Mentioning that one enjoyed vacuuming was accompanied with self-reflexive laughter and comments of being “weird”, which also revealed the importance ascribed to “choice”. Deliberately choosing to do a have-to-do occupation, made it easier to see it as an occupation.

Relativizing definitions: Taking the subject into account

The third aspect of the efforts to define occupation included a relativizing stance that accounted for the subject who was supposed to perform the occupations. The relativizing stance to defining occupation comprised efforts that did not focus on established criteria for occupations, or ways of valuing them. Instead, participants emphasized the need to take seriously how occupations must always be defined in relation to who was performing the occupations. This included differences between people but also the expected changes in one’s own future life.

The participants drew attention to how occupation was dependent on the capacity and interest of the individual. By adding such perspective, the participants displayed a stance of solidarity. For example, being mentally active could at first be dismissed as an occupation, but then, after reflection, be described as a “real” occupation for people with physical disabilities. One woman argued that “occupation is dependent on your possibilities” and another person stated that occupation is “dependent on what kind of person you are”. The participants thus emphasized the need to include other occupations for people who disagreed with, or could not live up to the demands of physical doing identified by the initial definition of occupation, and introduced alternative ways to evaluate occupations.

The participants also reflected on the changes that might come with aging. Participants spoke of their own experiences and emphasized how they might come to redefine their own occupations in the near future. Some participants simply stated that “then you’ll do other things, you adapt to life after what you can do” and “there will be new activities”. Other participants reflected a feeling of loss or change in occupations:

W2: The things that you don’t think are true occupations today … might become occupations!

W3: Mmm … the world will shrink.

W1: Yes, yes it will.

Discussion

The aim of this study was to explore how older adults described and negotiated definitions of occupations, to illustrate the importance of the emic perspective when describing and categorizing occupations. Important to note is that participants were able to reach agreement. However, occupations are commonly understood to also be “embedded and negotiated within … social systems and structures” (Laliberte Rudman, 2010, p. 55), see also (Hocking, 2000; Prodinger et al., 2015). In what follows, we will show how the studied discussions and the definitions that the participants arrived at may represent three overarching discourses related to aging: a discourse about active aging, about the third age, and a critical discourse.

Three structuring discourses

Echoing throughout all the workshop discussions were notions of active aging. The participants highlighted doings that required a physical effort that were instantly and nonnegotiably articulated as occupation, which meant that such doings were also readily recognized and accepted as occupations.

Developed in the 1990s (World Health Organization, 2002), the concept or discourse of active aging emphasized the link between being active and health (Foster & Walker, 2015). Even though most established definitions include being socially and mentally active alongside physical activity (World Health Organization, 2002), there have been concerns that policy makers will stress physical activity and productive aging (Barrett & McGoldrick, 2013). Such concerns suggest that the discourse of active aging still tends to privilege physical activity levels. This was visible in the discussions. For example, one participant suggested her group start with the category of physical doing because “that is nothing to discuss” and so self-evidently a form of occupation to her, was an apt example of this. Even though the participants often questioned their first definitions and came to agreements that other forms of doings could also be regarded as occupation, it was physical doings that were situated as primary occupations.

A second discourse, closely related to active ageing was the discourse of the third age (Laslett, 1989). The third age offers a way to understand post-working life as a period of activity and opportunity before entering ‘old age’. The third age ideals of independence, activity, and productivity have been described as consistent with normative Western values and are repeatedly referred to in studies of aging and occupation (e.g., Heatwole Shank & Cutchin, 2016; Kantartzis & Molineux, 2011). The discourse of the third age has been said to represent a “prominent resource for the redefinition of the representations of old age” (Marhánková, 2010, p. 8) away from inactivity and dependency and into activity, independence, self-responsibility, and self-care, including the “continuities of choice” (Gilleard & Higgs, 2008 p. 26). Such continued choices include how to narrate one’s own doings so that they fit within specific templates for occupation (Aldrich et al., 2014).

In present study, the participants emphasized how everything they did was their own choice and they talked about themselves as being very active. In that sense, they presented themselves as typical third-agers; their self-presentations were closely connected with normative ways of narrating the self within a discourse of the third age. Even though, and as shown in the previous section, the negotiations comprised descriptions of various experiences and approaches to occupation, it was representations of selves that coincided with third age identities that often came to dominate the discussions (cf. Lundgren, 2011).

However, the participants also employed what we have called a critical discourse, which rejected general definitions of occupation and explicitly privileged the needs and abilities of individuals who might not be able to perform according to the initial definition. The critical discourse opened up a stance of solidarity, where the needs of ‘Others’ were ensured. This position also tended to defend one’s own future selves who might not be able to live up to activity standards due to expected future frailty. In both aspects, the critical discourse implied a social imagery that did not “seek distance from the negativity of old age” (Gilleard & Higgs, 2013 p. 374), but rather worked to include the otherwise excluded fourth age into the imagery. It thus took the edge off the sometimes judgmental tone of the initial definition of occupation with its often taken for granted measures of value, and its silencing of the experiences connected to the fourth age.

Production of old age subject positions

Inherent to discourse theory is the recognition that discourses entail subject positions. The positions offered by the studied discourse of occupation had similarities with the positions offered by the more overarching discourses of active aging and the third age. In theorizing occupation the participants generally resisted constructions of inactivity and primarily evoked discourses that provided positively charged aging identities (cf. Breheny & Stephens, 2016). The negotiations privileged an aging subject that was likely to engage in physical exercise and social events, that could afford to disregard housework (take housework easy, not being completely identified with a tidy home), and that took pleasure in actively choosing their occupations. These subject positions remained privileged even when the initial discourse was relativized, e.g., when participants talked from within a critical discourse.

Our analysis showed that the production of identity not only took place on a general discursive level, but was also central within the group negotiations; just as much as the participants argued in favor of a certain understanding of occupation, they were also engaged in presenting and producing themselves within the group (cf. Lundgren, 2012). They repeatedly made sure to construct an “I” or a “we” that would be described as successful from the point of view of their own definitions of occupation. When participants explicated and agreed that they engaged mostly in social, pleasure, or physical occupations and that these “have to’s” occupations had less meaning in their lives, they consolidated third age and activity norms which established themselves as privileged within these norms.

Ideological occupations

There were certainly ideological aspects to the participants’ theorizing (cf. Laliberte Rudman, 2006; Laws, 1996). On the one hand, the participants’ initial establishment of a definition of occupation employed and consolidated the sanctioned discourses of active aging and the third age. It thus supported normative technologies of government to idealize, presuppose, and constitute independent, healthy, and active old age positions (Katz, 2005; Rose, 1999). Since the majority reported higher education and positioned themselves as closely connected to third age norms, this may further be indicative of what has been described as the investment of third age activity norms into Western middle-class norms (Bury, 1995), which may render alternative ways of understanding occupation invisible (Morgan, 2010; Prodinger et al., 2015).

On the other hand, the criticism delivered through the critical discourse’s vindication of more including classifications must be understood as ideological. When the participants made efforts to relativize their own first definitions of occupation, their reflections clearly gained momentum from notions of solidarity. Such reflections paved the way for a greater understanding not only of others but also of the participants’ own future and possibly frail selves (Lundgren, Liliequist, & Sjöstedt Landén, 2018). In this, notions structured by the critical discourse were in no sense un-ideological, but held the potential to criticize present neo-liberalizing policies that suggest individuals take increased responsibility for their own health (Katz, 2005).

The limitations of the study include the small convenience sample. The participants spoke the same language and lived in the same geographic region of Sweden. How participants in this study categorized occupations could therefore probably not be generalized to other groups. People in other cultures and with different educational and socio-economic circumstances may construct occupational categories differently. Further research is therefore warranted.

Concluding Remarks

The findings from this study reinforce the importance of studying occupation from an emic viewpoint. The findings provide occupational scientists and therapists with deepened understandings of how people might think about and understand occupation, which may in turn have consequences for how they respond to occupational science concepts and occupation-based interventions.

The way that the negotiations were positioned within the discursive realms of active aging and the third age worked to privilege doings that were understood as physical and out of the ordinary. Although the participants problematized their own definitions and made sincere efforts to negotiate the meaning of occupation, they did so from within the same discourses and with the limitations that they constituted. Rather than finding a language that emphasized social and mental doings as occupations in their own right, the participants often made efforts to define them as physical occupations. Thus, crying hysterically and thinking hard could be considered as occupations if the physical effort and energy-consuming workings of the brain were in focus.

The emphasis on physicality was primarily relativized through putting into the discussions the position of an ‘Other’ (or future self) who could not live up to the norms of the initial definition of occupation. Through this relativized focus, new doings could be defined as occupations. They were, however, mostly constituted as exceptions, possible to understand as occupations only insofar as one could imagine someone whose physical frailty required a more encompassing definition. In this sense, there was a tendency that the participants’ understandings not only authorized certain doings as natural occupations, but also sanctioned specific ideal subjectivities.

While physical occupations were tellable (Shuman, 2006), in the sense that they were both possible to measure and to describe, social and mental occupations seemed to require a language that the participants were less familiar with. This has consequences for what occupations will grant a person a sense of ‘having done something’ and thus also affects perceptions of interventions aiming at stimulating social and mental occupations. Interventions that suggest participants engage in social or mental occupations without providing them with a language that makes non-physical occupations comprehensible as occupations, would possibly risk devaluing the intervention and reduce the incentive to participate.

As a last note, the analyses showed that although the explicit aim of the discussions was to define and classify ‘occupation’, the participants were equally involved in producing subject positions for themselves. Acknowledging this does not mean that we wish to make a call for more individualistic perspectives on occupation. On the contrary, we argue that the individual preferences and perceptions that the participants brought into the discussions were influenced by context, specifically the overarching discourses of active aging and third age. However, it means that it is important to recognize how investment in, and production of identity was significant when participants negotiated the meaning of occupation.

Acknowledgements

The authors thank the group of older adults that shared their time and expertise with us when participating in the workshops.

Disclosure statement

No potential conflict of interest was reported by the author(s).

ORCID

Anna Sofia Lundgren http://orcid.org/0000-0002-8758-5704

Karen Atler http://orcid.org/0000-0002-3751-3948

Ingeborg Nilsson http://orcid.org/0000-0002-8265-5769

Additional information

Funding

This study was financially supported by the Strategic Research Area Health Care Science and Forte: Swedish Research Council for Health, Working Life and Welfare.

Notes

1 Of course, this means that another group of people may have interpreted occupation differently, thus destabilizing the discourse of occupation as it was formed by the participants. This might be a limitation of the study and also partly acknowledged by the participants themselves in their discussions. The problematic leads us to a well-known dilemma of qualitative studies in many fields; the difficulty of attracting participants from social strata other than the middle class (Ellard-Gray, Jeffrey, Choubak, & Crann, 2015). Although in this study we deliberately used a variety of approaches in order to recruit a heterogeneous sample, there was still a bias towards women and well-educated persons among those who accepted the invitation. Apart from the ethical reasons to use inclusive approaches, the role played by identity and identification in negotiating occupation is an important reason for researchers to engage more actively in attracting participants with varied experiences.

Appendix A. Data collection procedure during workshops

Table

Workshop 1
Minutes	Researchers’ role	Participants’ engagement
1-30	Welcome and presentation of project and researchers.
	Presentation of the two workshops and what to expect.
	Ethical procedure and written consent presented and distributed.	Completed by participants.
	Demographic questions and basic health forms presented and distributed.	Forms filled in by participants.
	Distribution of sticky notes.
	Researchers present the question “What occupations do you perceive people engage in on an everyday basis?” No definition of what the term occupation could entail is given.	Participants compile a stack of sticky notes, writing an occupation on each note.
	If researcher evaluates the need for a prompt, they ask the following question “what occupation do you perceive people engage in at different occasions?” Researchers give no examples on practices that could exemplify occupation.
		Participants write down as many occupations as they can think of.
	When all participants have finished writing, they are divided into smaller groups of three to five persons.
Coffee, tea and snacks provided
30-70	Researcher gives instructions to each small group: a) each group member will present their occupations, b) discuss similarities and differences in the occupations listed, and c) add any new occupations that come up during the group discussion.
	Researcher leaves the room and audio recordings of the discussions start.	The participants present and discuss in the small groups.
70-100	Researcher returns to the room and gives instructions to each small group to a) start sorting out the different sticky notes with written occupations into groups based on similarities, b) put them all on big pieces of paper that were distributed, and c) discuss how to label each group of occupations and write that up on the big piece of paper.
	Researcher leaves the room and audio recordings of the discussion continue.	The participants discuss in the small groups.
100-120	Researcher returns, collects all big pieces of papers with the grouped and labeled sticky notes with written occupations.
	Wrap-up where participants can share experiences from the workshop, raise questions or concerns. Information about time for next workshop.	Participants share their experience related to today’s activities and ask questions.

Workshop 2
Minutes	Researchers’ role	Participants’ engagement
1-10	Short update about previous workshop and what will happen during Workshop 2.
10-20	Researchers return all materials created from lst session to each small group.	Participants review the work to become re-acquainted with the content.
	Researcher instructs that a) each small group will present to the whole group on how they have sorted and labeled their written occupations, b) when all small groups have presented they are to discuss in the whole group how the different groups’ versions of sorting and labeling could be merged into one shared idea. The researcher carefully highlights that all different opinions and questions during the process of merging needed to be appreciated and discussed.
20-50	Researcher leaves the room.Audio recording starts.	Participants share their discussion from last workshop with each other and thereafter discuss possibilities to merge the different ideas into one shared idea.
50-60	Researcher returns to answer questions that may have emerged during discussions.
Coffee, tea and snacks provided
60-90	Audio recordings continue.	Participants continue with the discussions how to merge the different ideas into one shared idea that all participants agree on.
90-120	Researcher returns and asks the group to present their one shared idea on how to sort and label their sticky notes with written occupations.Audio recordings continue.	All participants are active in the discussion.
	Researcher ends the workshop by asking participants to share some experiences of being involved in discussions. Researcher describes the continuation of the project and thanks everyone for participating.	Participants share their experiences of being involved in the project.