Scales and tales: older women's difficulty with daily tasks.
OBJECTIVE
Part of a 3-year study of the home care experience among 25 older women (aged 80-96), this research aimed to describe how the women understood difficulty relative to 20 basic and instrumental activity of daily living tasks.


METHODS
This was a qualitative study with a quantitative component. During open-ended interviews about living alone with help, participants rated difficulty with tasks on a 1-to-5 scale and talked about difficulty relative to tasks. I estimated concordance of the first two ratings and used a descriptive phenomenological method to discern how participants understood difficulty.


RESULTS
Concordance was satisfactory for all tasks other than climbing stairs. Six elements of the life-world of older women were descriptive of difficulty relative to tasks, including pinpointing my biggest/hardest job and having difficulty rating difficulty. Whether reporting difficulty or not, some women spoke of taking extra time, extra effort, or both.


CONCLUSIONS
The findings suggest a counterview to functional limitation models. Difficulty was posed as a theoretical construct, and the concept of subliminal difficulty was introduced. Various facets of difficulty warrant further descriptive work. Incorporating an opportunity to talk about difficulty, as well as to rate it, would be valuable in large-scale studies.
Porter
Eileen J
EJ
MU Sinclair School of Nursing, University of Missouri-Columbia, Columbia, MO 65211, USA. PorterEJ@missouri.edu
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology*; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001364:Awareness; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006699:Home Care Services; D006801:Humans; D007407:Interviews as Topic; D008923:Missouri; D051346:Mobility Limitation; D010147:Pain Measurement / Q000451:nursing / Q000523:psychology; D005082:Physical Exertion; D012803:Sick Role