title: Shifting between self-governing and being governed: a qualitative study of older persons' self-determination.
abstract: BACKGROUND
  Older persons' right to exercise self-determination in daily life is supported by several laws. Research shows that older persons' self-determination is not fully respected within the healthcare sector. In order to enable and enhance older persons' self-determination, extensive knowledge of older persons' self-determination is needed. The aim of this study was to explore experiences of self-determination when developing dependence in daily activities among community-dwelling persons 80 years and older.
  
  
  METHODS
  Qualitative interviews were performed in accordance with a grounded theory method, with 11 persons aged 84-95 years who were beginning to develop dependence in daily activities.
  
  
  RESULTS
  The data analysis revealed the core category, "Self-determination - shifting between self-governing and being governed". The core category comprised three categories: "Struggling against the aging body", "Decision-making is relational", and "Guarding one's own independence". Self-determination in daily activities was related to a shifting, which was two-fold, and varied between self-governing and being governed by the aging body, or by others.
  
  
  CONCLUSIONS
  The findings imply a need to adopt a person-centered approach where the older persons' own preferences and needs are in focus, in order to enhance their possibilities to exercise self-determination.
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. isabelle.o-h@neuro.gu.se.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ottenvall Hammar
authors.forename: Synneve
authors.initials: S
authors.lastname: Dahlin-Ivanoff
authors.forename: Katarina
authors.initials: K
authors.lastname: Wilhelmson
authors.forename: Kajsa
authors.initials: K
authors.lastname: Eklund
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000369:Aged, 80 and over; D003657:Decision Making; D003858:Dependency, Psychological; D005260:Female; D006801:Humans; D008297:Male; D010358:Patient Participation / Q000639:trends*; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology*