Older rehabilitees’ life-course agency in Finnish gerontological rehabilitation

Abstract

Aims: This study investigates gerontological rehabilitation sessions of Finnish rehabilitees in the framework of life-course agency from the perspectives of temporal orientation and agency. Methods: The research data were obtained by non-participatory observation in 11 individual goal-setting sessions between 11 rehabilitees and their personal counsellors. The data were analysed in accordance with data-driven, qualitative content and narrative analysis, with an emphasis on the life-course agency approach. Results: Four temporal orientations of older rehabilitees were identified in the rehabilitation sessions: (i) timeless, (ii) past, (iii) present, and (iv) life course. For each temporal orientation, the rehabilitees displayed different kinds of agency. Fractured agency was intertwined with the timeless orientation, frozen agency was related to the past orientation, practical agency to the present orientation, and transitional agency emerged in relation to the life-course orientation. Conclusions: The article contributes to the discussion of how older adults’ rehabilitation should be reformed within the Finnish context. The study suggests that a person-centred gerontological rehabilitation process should be conceptualized in terms of an agency-based approach with a personally constructed and temporally embedded life-course perspective. This kind of conceptualizing could promote empowered cooperation and innovative interventions with flexible schedules in the rehabilitation processes of older adults.

Key words:

• Goal-setting
• agency
• occupational therapy
• person-centred rehabilitation
• temporality

Acknowledgements

The research presented in this article was supported by Kela, the Social Insurance Institution of Finland as part of the development project Co-operative Rehabilitation for Aged Rehabilitees (IKKU 2009–2013). The authors wish to thank the rehabilitees and their counsellors at the rehabilitation centres for their consideration and courage in opening up their rehabilitation sessions to the researcher. They would also like to thank Matthew Wuethrich at the University of Jyväskylä Language Services for polishing the language of the article. They are also grateful to the two anonymous referees for their helpful comments regarding this paper.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.