Perceptions of a good life for the oldest old living at home

Main Article Content

Ariel Almevall
Päivi Juuso
Karin Zingmark
Carina Nilsson


An increasing number of people are growing older and living longer in their homes. This study aims to describe key stakeholders’ (politicians, managers, and professionals) perceptions of a good life for single-living oldest old persons living at home with extensive needs for support. Inter­views with stakeholders were analysed with content analysis. The analy­sis resulted in the theme: An incongruence between intentions and actions in promoting a good life for the oldest old. Our findings show a gap between intentions and actions, which caused feelings of powerlessness in the key stakeholders. To promote a good life for the oldest old persons, a congruence is needed between individual awareness and the prerequisite of promoting a good life. Developing methods that identify and bridge gaps between intentions and actions could support the abilities of organ­isations to promote a good life for the oldest old persons with extensive needs for support.


Metrics Loading ...

Article Details



Almevall, A. D., Nordmark, S., Niklasson, J. & Zingmark, K. (2022). Ex¬periences of home as an aspect of well-being in people over 80 years: A mixed method study. Journal of Advanced Nursing 78(1), 252–263. doi:10.1111/jan.15093

Board, M. & McCormack, B. (2018). Exploring the meaning of home and its implications for the care of older people. Journal of Clinical Nursing 27(15–16), 3070–3080. doi:10.1111/jocn.14495

Brink, S. (1990). International policy trends in housing the elderly in developed countries. Ageing International 17(2), 13–20. doi:10.1007/ BF03004336

Buckinx, F., Rolland, Y., Reginster, J., Ricour, C., Petermans, J. & Bruyère, O. (2015). Burden of frailty in the elderly population: Perspectives for a public health challenge. Archives of Public Health 73(1), 1–7. doi:10.1186/ s13690-015-0068-x

Carlson, E., Rämgård, M., Bolmsjö, I. & Bengtsson, M. (2014). Registered nurses’ perceptions of their professional work in nursing homes and home-based care: A focus group study. International Journal of Nursing Studies 51(5), 761–767. doi:10.1016/j.ijnurstu.2013.10.002

Collard, R. M., Boter, H., Schoevers, R. A. & Oude Voshaar, R. C. (2012). Prevalence of frailty in community-dwelling older persons: A system¬atic review. Journal of the American Geriatrics Society 60(8), 1487–1492. doi:10.1111/j.1532-5415.2012.04054.x

Davey, J. A., De Joux, V., Nana, G. & Arcus, M. (2004). Accommodation Options for Older People in Aotearoa/New Zealand. Christchurch: Centre for Housing Research.

Dovey, K. (2005). Dimensions of the meaning of home in later life. In K. Dovey (ed.), Home and Identity in Late Life: International Perspectives (pp. 21–45). New York, NY: Springer Publishing Company.

Entwistle, V. A. & Watt, I. S. (2013). Treating patients as persons: A ca¬pabilities approach to support delivery of person-centered care. The American Journal of Bioethics 13(8), 29–39. doi:10.1080/15265161.2013. 802060

Evans, S. (2017). What should social welfare seek to achieve? applying the capability approach. Ethics and Social Welfare 11(1), 19–32. doi:10.1080/ 17496535.2016.1234632

Evertsson, P. & Rosengren, K. (2015). Political experiences of changing the focus in elderly care in one municipality. Journal of Nursing Manage¬ment 23(8): 994–1002. doi:10.1111/jonm.12245

Finnbakk, E., Skovdahl, K., Blix, E. S. & Fagerström, L. (2012). Top-level managers’ and politicians’ worries about future care for older people with complex and acute illnesses–a nordic study. International Journal of Older People Nursing 7(2), 163–172. doi:10.1111/j.1748-3743.2012.00312.x

Gautun, H. & Grødem, A. S. (2015). Prioritising care services: Do the old¬est users lose out? International Journal of Social Welfare 24(1), 73–80. doi:10.1111/ijsw.12116

Graneheim, U. H., Lindgren, B. M. & Lundman, B. (2017). Methodological challenges in qualitative content analysis: A discussion paper. Nurse Education Today 56(9), 29–34. doi: 10.1016/j.nedt.2017.06.002

Graneheim, U. H. & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 24(2), 105–112. doi:10.1016/j. nedt.2003.10.001

Grönlund, C. F., Dahlqvist, V., Zingmark, K., Sandlund, M. & Söderberg, A. (2016). Managing ethical difficulties in healthcare: Communicating in inter-professional clinical ethics support sessions. HEC Forum 28(4), 321–338. doi:10.1007/s10730-016-9303-2

Grove, H. (2021). Ageing as well as you can in place: Applying a geo¬graphical lens to the capability approach. Social Science & Medicine 288(20), 113525. doi: 10.1016/j.socscimed.2020.113525

Hendriks, P., van Doorn, L. & van Ewijk, H. J. (2016). Turkish and moroc¬can dutch professionals in social work. European Journal of Social Work 19(5), 679–691. doi:10.1080/13691457.2015.1030362

Hjelle, K. M., Skutle, O., Alvsvåg, H. & Førland, O. (2018). Reablement teams’ roles: A qualitative study of interdisciplinary teams’ expe¬riences. Journal of Multidisciplinary Healthcare 11(1), 305–316. doi: 10.2147/jmdh.s160480

Horrell, B., Breheny, M. & Stephens, C. (2020). Using nussbaum’s central capabilities to understand caring for older people in New Zealand. In¬ternational Journal of Care and Caring 4(4), 531–547. doi:10.1332/239788 220X15936247038641

Hugman, R. (2008). Social work values: Equity or equality? A response to solas. Australian Social Work 61(2), 141–145. doi:10.1080/03124070801998400

Iwarsson, S., Horstmann, V. & Slaug, B. (2007). Housing matters in very old age – yet differently due to ADL dependence level dif¬ferences. Scandinavian Journal of Occupational Therapy 14(1), 3–15. doi:10.1080/11038120601094732

Kelly, D. A. (1975). Home as a philosophical problem. The Modern School¬man 52(2), 151–168. doi:10.5840/schoolman19755223

Krueger, R. A. (2014). Focus groups: A practical guide for applied research (5th ed.). CA: Sage publications.

Martin, D., Long, O. & Kessler, L. (2019). Planning for aging in place: Incor¬porating the voice of elders to promote quality of life. Journal of Housing for the Elderly 33(4), 382–392. doi:10.1080/02763893.2019.1593280

Melander, C., Sävenstedt, S., Wälivaara, B. & Olsson, M. (2018). Human capabilities in advanced dementia: Nussbaum’s approach. International Journal of Older People Nursing 13(2), e12178. doi:10.1111/opn.12178

Molewijk, A. C., Abma, T., Stolper, M. & Widdershoven, G. (2008). Teaching ethics in the clinic. The theory and practice of moral case deliberation. Journal of Medical Ethics 34(2), 120–124. doi:10.1136/jme.2006.018580

Morgan, D. L. (1997). Qualitative Research Methods. Thousand Oaks, CA: Sage.

Nussbaum, M. C. (2000). The costs of tragedy: Some moral limits of cost-benefit analysis. The Journal of Legal Studies 29(S2), 1005–1036. doi:10.1086/468103

Nussbaum, M. C. (2011). Creating Capabilities: The Human Development Approach. Cambridge, MA: Belknap Press of Harvard.

Oswald, F. & Wahl, H. (2005). Dimensions of the meaning of home in later life. In G. Rowles (ed.), Home and identity in late life: International per¬spectives (pp. 21–45). New York, NY: Springer Publishing Company.

Pirhonen, J. (2015). Dignity and the capabilities approach in long-term care for older people. Nursing Philosophy 16(1), 29–39. doi:10.1111/ nup.12057

QSR International Pty Ltd. (2018). NVivo (Version 11)., Available on https:// home

Rechel, B., Grundy, E., Robine, J., Cylus, J., Mackenbach, J. P., Knai, C. & McKee, M. (2013). Ageing in the european union. The Lancet 381(9874), 1312–1322. doi:10.1016/S0140-6736(12)62087-X

Seeman, M. (1959). On the meaning of alienation. American Sociological Review 24(6) 783–791. doi:10.2307/2088565

Social Services Act. (2001). Socialtjänstlagen (2001:453) [Social Ser¬vices Act]. Available on¬kument - lagar/dokument/svensk-for fat t n ingssaml ing/ socialtjanstlag-2001453_sfs-2001-453

Statistics Sweden. (2017). The future population of sweden 2017–2060. Retrieved from

Stone, M. E., Lin, J., Dannefer, D. & Kelley-Moore, J. A. (2017). The continued eclipse of heterogeneity in gerontological research. The Journals of Gerontology: Series B 72(1), 162–167. doi:10.1093/geronb/ gbv068

Swedish Institute. (2021). Elderly Care in Sweden. Available on https://

Tellez, J., Krishnakumar, J., Bungener, M. & Le Galès, C. (2016). Capability deprivation of people with Alzheimer’s disease: An empirical analysis using a national survey. Social Science & Medicine 151(4), 56–68. doi: 10.1016/j.socscimed.2015.12.032

Tuominen, K. & Pirhonen, J. (2019). “Who would take a 90-year-old?” com¬munity-dwelling nonagenarians’ perceptions of social relationships. International Journal of Ageing and Later Life 13(1), 111–137. doi:10.3384/ ijal.1652-8670.18387

Vasunilashorn, S., Steinman, B. A., Liebig, P. S. & Pynoos, J. (2012). Aging in place: Evolution of a research topic whose time has come. Journal of Aging Research 2012, 120952. doi: 10.1155/2012/120952

Wiles, J. L., Leibing, A., Guberman, N., Reeve, J. & Allen, R. E. (2012). The meaning of “aging in place” to older people. The Gerontologist 52(3), 357–366. doi:10.1093/geront/gnr098

World Health Organization. (2007). Global age-friendly cities proj¬ect. Retrieved from

World Health Organization. (2012). Good health adds life to years: Global brief for world health day 2012. Retrieved from¬friendlyworld/good-health-adds-life-to-years-global-brief-on-world-health-day-2012/.

Zingmark, K. (2000). Experiences related to home in people with Alzheimer’s Disease. Dissertation, Umeå University.