Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T18:52:41.278Z Has data issue: false hasContentIssue false

‘Old but not that old’: Finnish community-dwelling people aged 90+ negotiating their autonomy

Published online by Cambridge University Press:  03 June 2015

JARI PIRHONEN*
Affiliation:
School of Health Sciences and Gerontology Research Center, University of Tampere, Finland.
HANNA OJALA
Affiliation:
School of Social Sciences and Humanities, University of Tampere, Finland.
KIRSI LUMME-SANDT
Affiliation:
School of Health Sciences and Gerontology Research Center, University of Tampere, Finland.
ILKKA PIETILÄ
Affiliation:
School of Health Sciences and Gerontology Research Center, University of Tampere, Finland.
*
Address for correspondence: Jari Pirhonen, School of Health Sciences, 33014University of Tampere, Finland E-mail: [email protected]

Abstract

Autonomy is a pervasive concept in Western lifestyles today. However, people in the fourth age are assumed not to be autonomous but dependent on other people. The data of this study consisted of interviews with Finnish community-dwelling 90–91-year-old people. The study aim was to examine how these people see their own autonomy in their everyday lives. The analysis was based on membership categorisation analysis. Our respondents considered their autonomy through three distinct themes. Functional ability was considered in terms of being physically capable of managing daily tasks. Independence in decision making was based on material and financial self-sufficiency and on the respondents' supposition that they were capable of making decisions due to an absence of memory disorders. Additionally, autonomy was considered as contesting norms of age-appropriateness. Among respondents, chronological age seemed to have been replaced by functional and cognitive ability as a definer of categorisations; age-others became ability-others. Our study revealed that the perceptions of autonomy also included gendered features as they were linked with differing gendered ideals, roles and life domains of women and men. The results highlight the internal diversity among the oldest old and challenge the third/fourth age division. Instead, they suggest the existence of a certain ‘grey area’ within old age, and urge an analysis on the subtle meaning making involved in older people's constructions of age-categorisations.

Type
Articles
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agich, G. J. 2003. Dependence and Autonomy in Old Age. An Ethical Framework for Long-term Care. Cambridge University Press, Cambridge.Google Scholar
Antaki, C. and Widdicombe, S. 1998. Identities in Talk. Sage, London.Google Scholar
Baker, C. 1997. Membership categorization and interview accounts. In Silverman, D. (ed.), Qualitative Research. Theory, Method and Practice. Sage, London, 130–43.Google Scholar
Baltes, P. B. and Smith, J. 2003. New frontiers in the future of aging: from successful aging of the young old to the dilemmas of the fourth age. Gerontology, 49, 2, 123–35.CrossRefGoogle Scholar
Ben-Zur, H. 2002. Coping, affect and aging: the roles of mastery and self-esteem. Personality and Individual Differences, 32, 2, 357–72.CrossRefGoogle Scholar
Berg, A. I., Hassing, L. B., McClearn, G. E. and Johansson, B. 2006. What matters for life satisfaction in the oldest old? Aging & Mental Health, 10, 3, 257–64.CrossRefGoogle ScholarPubMed
Beswick, A. D., Rees, K., Dieppe, P., Ayis, S., Gooberman-Hill, R., Horwood, J. and Ebrahim, S. 2008. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. The Lancet, 371, 9614, 725–35.CrossRefGoogle ScholarPubMed
Bowker, G. C. and Star, S. L. 1999. Sorting Things Out. Classification and its Consequences. MIT Press, Cambridge, Massachusetts.Google Scholar
Calasanti, T. 2003. Theorizing age relations. In Biggs, S., Lowenstein, A. and Hendricks, J. (eds), The Need for Theory. Critical Approaches to Social Gerontology for the 21st Century. Baywood, Amityville, New York, 199218.Google Scholar
Calasanti, T. 2004. Feminist gerontology and old men. Journals of Gerontology: Psychological Sciences and Social Sciences, 59B, 6, 305–14.Google Scholar
Coupland, J. 2009. Discourse, identity and change in mid-to-late life: interdisciplinary perspectives on language and ageing. Ageing & Society, 29, 6, 849–61.CrossRefGoogle Scholar
Cummins, J. 1996. Negotiating Identities: Education for Empowerment in a Diverse Society. California Association for Bilingual Education, Ontario.Google Scholar
Davidson, K. 2008. Declining health and competence: men facing choices about driving cessation. Generations, 32, 1, 44–7.Google Scholar
Degnen, C. 2007. Minding the gap: the construction of old age and oldness amongst peers. Journal of Aging Studies, 21, 1, 6980.Google Scholar
Enkvist, A., Ekström, H. and Elmståhl, S. 2012. What factors affect life satisfaction (LS) among the oldest old? Archives of Gerontology and Geriatrics, 54, 1, 140–5.Google Scholar
Enroth, L., Raitanen, J., Hervonen, A. and Jylhä, M. 2013. Do socioeconomic health differences persist in nonagenarians? Journals of Gerontology: Psychological Sciences and Social Sciences, 68B, 5, 837–47.Google Scholar
Ethier, K. A. and Deaux, K. 1994. Negotiating social identity when contexts change: maintaining identification and responding to threat. Journal of Personality and Social Psychology, 67, 2, 243–51.Google Scholar
Featherstone, M. and Hepworth, M. 1989. Ageing and old age: reflections of the postmodern life course. In Bytheway, B., Keil, T., Allat, P. and Bryman, A. (eds), Becoming and Being Old: Sociological Approaches to Later Life. Sage, London, 143–57.Google Scholar
Finlex 2012. Act on Supporting the Functional Capacity of the Older Population and on Social and Health Services for Older Persons. Available online at http://www.finlex.fi/en/laki/kaannokset/2012/en20120980 [Accessed 10 August 2014].Google Scholar
Fleming, A. 1999. Older men in contemporary discourses on ageing: absent bodies and invisible lives. Nursing Inquiry, 6, 1, 38.Google Scholar
Garfinkel, H. 1967. Studies in Ethnomethodology. Prentice Hall, Englewood Cliffs, New Jersey.Google Scholar
Gilleard, C. and Higgs, P. 2000. Cultures of Ageing. Self, Citizen and the Body. Prentice Hall, London.Google Scholar
Gilleard, C. and Higgs, P. 2010. Aging without agency. Theorizing the fourth age. Aging and Mental Health, 14, 2, 121–8.Google Scholar
Gilleard, C. and Higgs, P. 2011 a. Ageing abjection and embodiment in the fourth age. Journal of Aging Studies, 25, 2, 135–42.Google Scholar
Gilleard, C. and Higgs, P. 2011 b. Frailty, disability and old age. A re-appraisal. Health, 15, 5, 475–90.Google Scholar
Gilleard, C. and Higgs, P. 2013. The fourth age and the concept of a ‘social imaginary’. A theoretical excursus. Journal of Aging Studies, 27, 4, 368–76.Google Scholar
Häggblom-Kronlöf, G., Hultberg, J., Eriksson, B. G. and Sonn, U. 2007. Experiences of daily occupations at 99 years old. Scandinavian Journal of Occupational Therapy, 14, 3, 192200.Google Scholar
Heikkinen, R. 2004. The experience of ageing and advanced old age: a ten-year follow-up. Ageing & Society, 24, 4, 567–82.CrossRefGoogle Scholar
Horgas, A. L., Wilms, H. U. and Baltes, M. M. 1998. Daily life in very old age: everyday activities as expression of successful living. The Gerontologist, 38, 5, 556–68.Google Scholar
Hurd, L. C. 1999. ‘WE'RE NOT OLD!’: older women's negotiation of aging and oldness. Journal of Aging Studies, 13, 4, 419–39.Google Scholar
Jolanki, O. 2009. Fate of Choice? Talking About Old Age and Health. Tampere University Press, Tampere, Finland.Google Scholar
Jylhä, M. 1994. Self-rated health revisited: exploring survey interview episodes with elderly respondents. Social Science and Medicine, 39, 7, 983–90.Google Scholar
Jylhä, M., Paavilainen, P., Lehtimäki, T., Goebeler, S., Karhunen, P. J., Hervonen, A. and Hurme, M. 2007. Interleukin-1 receptor antagonist, interleukin-6, and C-reactive protein as predictors of mortality in nonagenarians: the Vitality 90+ study. Journals of Gerontology: Biological Sciences and Medical Sciences, 62A, 9, 1016–21.Google Scholar
Kaufman, S. R. 1986. The Ageless Self. Sources of Meaning in Late Life. The University of Wisconsin Press, Madison, Wisconsin.Google Scholar
Kayser-Jones, J. 1981. Old, Alone and Neglected. Care of the Aged in Scotland and the United States. University of California Press, Berkeley, California.Google Scholar
King, J., Yourman, L., Ahalt, C., Eng, C., Knight, S. J., Pérez-Stable, E. J. and Smith, A. K. 2012. Quality of life in late-life disability: ‘I don't feel bitter because I am in a wheelchair’. Journal of the American Geriatrics Society, 60, 3, 569–76.Google Scholar
Kontos, P. C. 1998. Resisting institutionalization: constructing old age and negotiating home. Journal of Aging Studies, 12, 2, 167–84.Google Scholar
Laslett, P. 1989. A Fresh Map of Life. The Emergence of the Third Age. Weidenfeld and Nicolson, London.Google Scholar
Laz, C. 2003. Age embodied. Journal of Aging Studies, 17, 4, 503–19.CrossRefGoogle Scholar
Leveille, S. G., Penninx, B. W., Melzer, D., Izmirlian, G. and Guralnik, J. M. 2000. Sex differences in the prevalence of mobility disability in old age: the dynamics of incidence, recovery, and mortality. Journals of Gerontology: Psychological Sciences and Social Sciences, 55B, 1, 4150.Google Scholar
Lisko, I., Tiainen, K., Stenholm, S., Luukkaala, T., Hervonen, A. and Jylhä, M. 2011. Body mass index, waist circumference, and waist-to-hip ratio as predictors of mortality in nonagenarians: the Vitality 90+ study. Journals of Gerontology: Biological Sciences and Medical Sciences, 66A, 11, 1244–50.Google Scholar
Lloyd, L., Calnan, M., Cameron, A., Seymour, J. and Smith, R. 2014. Identity in the fourth age: perseverance, adaptation and maintaining dignity. Ageing & Society, 34, 1, 119.Google Scholar
Minichiello, V., Browne, J. and Kendig, H. 2000. Perceptions and consequences of ageism: views of older people. Ageing & Society, 20, 3, 253–78.Google Scholar
Myerhoff, B. 1984. Rites and signs of ripening: the interweaving of ritual, time and growing older. In Kertzer, D. and Keith, J. (eds), Age and Anthropological Theory. Cornell University Press, Ithaca, New York, 305–30.Google Scholar
Nikander, P. 2000. ‘Old’ versus ‘little girl’: a discursive approach to age categorization and mortality. Journal of Aging Studies, 14, 4, 335–58.Google Scholar
Nikander, P. 2002. Age in Action. Membership Work and Stage of Life Categories in Talk. Academia Scientiarum Fennica, Helsinki.Google Scholar
Nikander, P. 2009. Doing change and continuity: age identity and the micro–macro divide. Ageing & Society, 29, 6, 863–81.CrossRefGoogle Scholar
Ouwehand, C., de Ridder, D. T. and Bensing, J. M. 2007. A review of successful aging models: proposing proactive coping as an important additional strategy. Clinical Psychology Review, 27, 8, 873–84.Google Scholar
Ozaki, A., Uchiyama, M., Tagaya, H., Ohida, T. and Ogihara, R. 2007. The Japanese centenarian study: autonomy was associated with health practices as well as physical status. Journal of the American Geriatrics Society, 55, 1, 95101.Google Scholar
Perrig-Chiello, P., Perrig, W. J., Uebelbacher, A. and Stähelin, H. B. 2006. Impact of physical and psychological resources on functional autonomy in old age. Psychology, Health & Medicine, 11, 4, 470–82.Google Scholar
Pietilä, I. and Ojala, H. 2011. Acting age in the context of health: middle-aged working-class men talking about bodies and aging. Journal of Aging Studies, 25, 4, 380–9.Google Scholar
Pietilä, I., Ojala, H., King, N. and Calasanti, T. 2013. Aging male bodies, health and the reproduction of age relations. Journal of Aging Studies, 27, 3, 243–51.Google Scholar
Plath, D. 2008. Independence in old age: the route to social exclusion? British Journal of Social Work, 38, 7, 1353–69.Google Scholar
Portacolone, E. 2011. The myth of independence for older Americans living alone in the Bay Area of San Francisco: a critical reflection. Ageing & Society, 31, 5, 803–28.Google Scholar
Queniart, A. and Charpentier, M. 2011. Older women and their representations of old age: a qualitative analysis. Ageing & Society, 32, 6, 9831007.CrossRefGoogle Scholar
Sacks, H. 1992 a. Lectures on Conversation. Volume 1, Jefferson, G. (ed.). Blackwell, Oxford.Google Scholar
Sacks, H. 1992 b. Lectures on Conversation. Volume 2, Jefferson, G. (ed.). Blackwell, Oxford.Google Scholar
Salari, S. M. 2006. Infantilization as elder mistreatment: evidence from five adult day centers. Journal of Elder Abuse & Neglect, 17, 4, 5391.Google Scholar
Salari, S. M. and Rich, M. 2001. Social and environmental infantilization of aged persons: observations in two adult day care centers. International Journal of Aging and Human Development, 52, 2, 115–34.Google Scholar
Sarvimäki, A. and Stenbock-Hult, B. 2000. Quality of life in old age described as a sense of well-being, meaning and value. Journal of Advanced Nursing, 32, 4, 1025–33.Google Scholar
Schafer, M. H., Mustillo, S. A. and Ferraro, K. F. 2013. Age and the tenses of life satisfaction. Journals of Gerontology: Psychological Sciences and Social Sciences, 68B, 4, 571–79.Google Scholar
Schwanen, T. and Ziegler, F. 2011. Wellbeing, independence and mobility: an introduction. Ageing & Society, 31, 5, 719–33.Google Scholar
Siren, A. and Haustein, S. 2014. What are the impacts of giving up the driving licence? Ageing & Society. Published online: 24 June 2014, doi:10.1017/S0144686X14000610.Google Scholar
Speer, S. A. and Stokoe, E. 2011. Conversation and Gender. Cambridge University Press, Cambridge.Google Scholar
Stephenson, P. H., Wolfe, N. K., Coughlan, R. and Koehn, S. D. 2000. A methodological discourse on gender, independence, and frailty: applied dimensions of identity construction in old age. Journal of Aging Studies, 13, 4, 391401.Google Scholar
Thompson, E. H. 2006. Images of old men's masculinity: still a man? Sex Roles, 55, 9/10, 633–48.Google Scholar
Townsend, J., Godfrey, M. and Denby, T. 2006. Heroines, villains and victims: older people's perceptions of others. Ageing & Society, 26, 6, 883900.Google Scholar
Tulle, E. 2007. Running to run: embodiment, structure and agency amongst veteran elite runners. Sociology, 41, 2, 329–46.Google Scholar
Twigg, J. 2004. The body, gender, and age. Feminist insights in social gerontology. Journal of Aging Studies, 18, 1, 5973.Google Scholar
Williams, S. J., Higgs, P. and Katz, S. 2012. Neuroculture, active ageing and the ‘older brain’. Problems, promises and prospects. Sociology of Health and Illness, 34, 1, 6478.CrossRefGoogle ScholarPubMed