title: Balancing struggles with desired results in everyday activities: strategies for elderly persons with physical disabilities.
abstract: The number of elderly persons with disabilities needing support with everyday activities increasing in Japan and around the world. Yet, engagement in everyday activities can support the quality of their daily life. Despite research focusing on reported meanings of people's actions, there is still limited knowledge on how engagement in everyday activity is enacted along with the meanings of persons' actions. The aim of the present study was to identify meanings of persons' actions within everyday activities of elderly Japanese with physical disabilities. Five elderly persons with physical disabilities living in the community participated in this study. Data were gathered by 10 participant observations of everyday activities supplemented with 13 unstructured interviews. Narrative analysis was used to identify meanings of persons' actions. The analysis identified an overall plot termed 'balancing struggles with desired results'. This plot illustrated that participants' and other involved individuals balanced problematic situations with finding situations that accommodated their needs. Meanings of these actions were further identified as three complementary strategies. Two of three strategies aimed to mitigate given problems, one by 'acting on a plan to achieve one's goals', the other by 'taking a step in a preferred direction by capitalising on emerging opportunities'. The third strategy focused on avoiding undesirable experiences by 'modifying problematic situations'. In conclusion, these findings call for care and rehabilitation providers' sensitivity to shifting foci of what matters in daily life's situations as well as aligning with persons' skills, resources and perspectives. Accordingly, the judicious and flexible use of these complementary strategies can enhance elderly persons' quality of daily living through everyday activities.
authors.affiliation: Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Higashiogu, Tokyo, Japan.
authors.forename: Peter
authors.initials: P
authors.lastname: Bontje
authors.affiliation: Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Higashiogu, Tokyo, Japan.|Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Eric
authors.initials: E
authors.lastname: Asaba
authors.affiliation: Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.|Sør-Trøndelag University College, Department of Health and Social Science, Trondheim, Norway.|Division of Health and Rehabilitation, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Josephsson
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D012944:Social Support
keywords: Japanese; activities of daily living; ageing; care; meaning; narrative; occupational therapy; older adults; quality of daily living; transaction