Functional ability: Coping or self-actualisation?

Vilhelmiina Lehto interviewed nurses and elderly residents at a 24-hour care facility about their perceptions of functional ability.

Vilhelmiina Lehto interviewed nurses and elderly residents at a 24-hour care facility about their perceptions of functional ability. – Photograph: Jonne Renvall

For the first part of her doctoral dissertation on elderly care, University of Tampere researcher Vilhelmiina Lehto interviewed nurses and elderly residents at a 24-hour care facility about their perceptions of functional ability. Lehto’s results showed that the nurses’ perceptions were considerably narrower than those of the residents.

1. Functional abilities and the need to maintain functioning are a key part of elderly care, a fact that is even mentioned in legislation. However, Lehto’s ongoing study is the first to investigate how different actors understand functional ability.

2. According to Lehto’s data, nurses primarily evaluate functional abilities as daily activities, such as the ability to move and eat. The residents’ own definitions of functional abilities were considerably more varied and could refer to, for example, their past occupation. For instance, a former artist described the extent to which he is still able to paint, as well as the extent to which he has had to abandon making art.

3. Differences in the views may have an effect on the success of rehabilitation and the maintenance of functioning. The way in which functional abilities are talked about has a bearing on the culture of the care organisation. Attention should also be paid to whether the older people are treated as recipients of care or as active agents.

4. Functional ability and its meaning should be discussed with the residents or, if necessary, with their family members. This would uncover what kinds of abilities are important and meaningful to the individual older person so that rehabilitation could be tailored to address those factors. The maintenance of functioning should also be monitored.

5. Actions aimed at maintaining functioning in a meaningful way might enable the most intense and expensive care phase to be postponed. It would therefore be worthwhile to take functional abilities into account earlier, in home care as well as in 24-hour care.

Lehto interviewed 24 nurses and 16 residents at eight 24-hour long-term care facilities. The interviews revealed information regarding the participants’ understanding of older people’s functional ability, the way they describe it, and the kind of things they associate with it. Lehto’s study is part of her broader PhD research that explores the differences and similarities in how functional ability and rehabilitation are understood in long-term elderly care and the issues are attached to it. The study was published in the Journal of Aging Studies 43 (2017) 15–22.

Text: Hanna Hyvärinen