Lived Experiences of the Oldest Old

PURPOSE: The purpose of this study was to explore the lived experience of individuals older than age 80 yr. Research questions were as follows: What is life like for the oldest old? What challenges do these individuals encounter on a day-to-day basis? For what aspects of life do they rely on others? How do they cope with obstacles? How is their life satisfaction?

RATIONALE: The increasing size of this group warrants attention to their specific needs. It is projected that this population will increase to 219 million people by 2050, an 82% increase from 2009.

DESIGN: A qualitative and descriptive research design with rich narrative description was used.

PARTICIPANTS: Criteria for inclusion required participants to be of either gender, age 80 and older, of any ethnicity or race, and living in personal care or skilled nursing homes. Facility staff invited residents older than age 80 to participate.

METHOD: Researchers explained all aspects of the study including confidentiality, right to withdraw, expectations, recording, and transcribing procedures. Willing participants reviewed and signed informed consent forms. The Mini-Mental State Examination was conducted on each willing participant to determine suitability for inclusion. Upon achieving a minimum score of 20 out of 30, participants completed a demographic data sheet. Twelve participants were then individually interviewed for 1 hr using predetermined open-ended questions. Interview transcriptions were then made.

ANALYSIS: Researchers conducted content analyses of each transcript. Multiple categories of information were identified and organized in a data matrix illustrating key findings within and across all participants. Categories were blended into common themes via color coding. Key quotes and rich narrative description from each interview were used to illustrate each theme.

RESULTS: Findings showed our diverse participants shared these common themes: Families are essential for life fulfillment; religion often provides inner peace; traditional female occupations are important; marriages are vital; happy childhood produces fond memories; life satisfaction and socialization offer comfort; working and serving others continues to generate intrinsic gratification; and leisure occupations bring pleasure.

DISCUSSION: Results indicated these oldest old were very satisfied with their lives. They looked back at their lives with dignity and satisfaction. We found that, in spite of physical limitations, many of the participants were actually mentally astute and, although somewhat sedentary, were still engaged and content with their lives. We discovered that they lived in personal care homes or skilled nursing facilities because of physical decline, need for safety, and companionship. We learned that participants coped by connecting with living family members, conversations with others, and reflecting on pleasant memories. Our results concurred with researchers who said that family is an important support system for these individuals. We strongly recommend occupational therapists promote family involvement, encourage socialization, support leisure involvement, and foster reminiscence for this population.

The National Institute on Aging/World Health Organization stated that services for the aging are greatly needed. We contend that occupational therapy can play a lead role in helping this population live independently and with dignity.

IMPACT STATEMENT: The themes we found support the role of occupational therapy in the practice area of productive aging. As a key practice area in the American Occupational Therapy Association’s Centennial Vision, occupational therapists aid with productive aging by focusing on quality of life issues and keeping older adults independent, safe, and functional.