title: Older people's dependence on caregivers' help in their own homes and their lived experiences of their opportunity to make independent decisions.
abstract: OBJECTIVE
  The aim of this study was to illuminate the meaning of older people's dependence on caregivers' help, and of their opportunity to make independent decisions.
  
  
  BACKGROUND
  Throughout the world, the older population is growing, and in Sweden, the system of care for older people is currently undergoing change. Older people in the need of care are expected to live at home for as long as possible.
  
  
  METHODS
  A qualitative and life world approach was used.
  
  
  METHODS
  Audio-taped interviews were conducted with twelve older persons living at home, dependent on daily municipal home help service. A phenomenological hermeneutic method was utilised to disclose the meanings of lived experiences.
  
  
  RESULTS
  The findings revealed three themes: being facilitated to make one's own decisions, being hindered from making one's own decisions, struggling for vs. resigning oneself to losing the opportunity to make one's own decisions. The comprehensive understanding revealed that as older people become more dependent on caregivers' help, their opportunity to self-determine is challenged and this is stressful for them.
  
  
  CONCLUSIONS
  The older persons assess their opportunity to self-determine differently, depending on who they are as a person. The caregivers need an awareness of this, and further research is needed to gain knowledge and understanding of how caregivers can improve the way they support and enhance older people's opportunity to decide for themselves.
  
  
  CONCLUSIONS
  The findings revealed older persons need to exercise more self-determination and caregivers' need for knowledge to enable this. Further, it indicates a move towards a person-centred approach to focus on persons as individuals and see them as interdependent. The findings contribute to improvements in similar contexts worldwide.
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. agneta.breitholtz@mdh.se
authors: Agneta
authors: A
authors: Breitholtz
authors: Ingrid
authors: I
authors: Snellman
authors: Ingegerd
authors: I
authors: Fagerberg
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D017028:Caregivers / Q000523:psychology; D003152:Community Health Nursing; D003657:Decision Making; D003858:Dependency, Psychological; D005260:Female; D005851:Geriatric Nursing; D016852:Housing for the Elderly; D006801:Humans; D008297:Male; D015404:Nursing Methodology Research; D012648:Self Care / Q000523:psychology*; D013548:Sweden