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Helsinki, Finland

Mahler M.,Nordic School of Public Health | Sarvimaki A.,Age Institute
International Journal of Qualitative Studies on Health and Well-being | Year: 2012

Falling among older adults is a well-known public health problem but the association between falling and appetite is seldom studied although poor nutritional status is accepted as a risk factor for falls. On this background the aim of this study was to understand how older adults, who have fallen several times within a year, related their experiences of appetite as a phenomenon in everyday life. In narrative in-depth interviews, eight women and four men contributed with their stories. Using interpretative phenomenology the thematic analysis resulted in three main themes: appetite for food; appetite for social relations and appetite for influence. Eating was not trivial everyday routine and required self-regimentation. Meals were not an object of desire, but of discipline out of the wish to survive. Feelings, reflections and ambivalence were bound to the lack of appetite on food. The participants were oriented towards the forbidden, the delicious and to everyday food as a strengthener and as medicine. In their dependency on help, home was the framework for establishing social relations as means of social support. As well as family and neighbours, the significant others were persons on whom the participants were dependent. Personal relationships and mutual dependencies may ensure social security in lives characterised by contingency and maintain influence in daily life. Falling is both a dramatic and a trivial incident where life and death could be at stake. From this perspective, connectedness was prominent in all fall stories. The quest for influence and a sense of social connectedness was the incentive to re-enter local community arenas and to express solidarity. In health-care practice multi-factorial fall-prevention should be complemented with a multi-dimensional approach in order to balance the medical approach with humanistic and societal approaches towards fall-prevention. Copyright © 2012 N. Dauman & S. I. Erlandsson.


Sulander T.,Age Institute | Sulander T.,University of Helsinki
Archives of Gerontology and Geriatrics | Year: 2011

The present study was aimed to examine whether functional capacity among the urban home-dwelling older adults associates with health-related behavior. We also examined whether health-related behavior and certain diseases can be seen as mechanisms explaining socioeconomic disparities in functional capacity. A cross-sectional survey from 2008 was used to study 1395 older adults aged 75 and over living in one of the central areas of the city center of Helsinki, the capital of Finland. Associations of activities of daily living (ADL) with, smoking, food habits, physical activity, socioeconomic status and certain diseases were tested using ordinal regression model. Current smokers had slightly poorer functional ability than non-smokers among men. Those who did not use vegetables and/or fruits daily had a poorer functional capacity than daily users. Physically inactive respondents had clearly poorer functional capacity in comparison to active ones. Those with lower education had poorer functional status than higher educated irrespective of health-related behaviors and certain diseases. As health-related behaviors are modifiable, intervention programs should be targeted at all older adults with or without health problems. © 2010 Elsevier Ireland Ltd.


Nivala S.,University of Jyvaskyla | Sarvimaki A.,Age Institute
Aging and Mental Health | Year: 2015

Objectives: In many countries veterans from World War II are growing old. Research has shown that war experiences continue to impact those who have been involved in war for a long time. The present study targets old injured war veterans from World War II in Finland. The aim of this study was to produce knowledge of the impact of war experiences and injuries on the lifespan of Finnish war veterans.Method: The method used was grounded theory. Data were collected by interviewing 20 aged war veterans in their homes.Results: The analysis resulted in four categories, with also subcategories: (1) lost childhood and youth; (2) war traumas impacting life; (3) starting life from scratch; and (4) finding one's own place. A substantive theory of war veterans lifelong struggle for freedom throughout the lifespan was outlined.Conclusion: The war overshadowed the whole lifespan of the veterans, but in old age they finally felt free. Since war experiences vary depending on historical context, a formal theory would require additional research. © 2014 Taylor and Francis.


Nummela O.,Finnish National Institute for Health and Welfare | Sulander T.,University of Helsinki | Sulander T.,Age Institute | Helakorpi S.,Finnish National Institute for Health and Welfare | And 6 more authors.
Journal of Clinical Epidemiology | Year: 2011

Objectives: To examine nonparticipation in a survey by linking it with register information and identify potential nonresponse bias of inequalities in health status among aging people. Study Design and Setting: Cross-sectional questionnaire survey with clinical checkups carried out in 2002 among persons born in 1926-1930, 1936-1940, and 1946-1950 in Southern Finland. The sample was linked with register information from Statistics Finland and analyzed in terms of participation and health status as measured by medicine reimbursements. Results: Participation in the survey was more frequent among those who were older, female, married or cohabiting, higher educated and nonurban residents, and those with higher income and moderate health. Among nonrespondents, women were less healthy than men, whereas among respondents, the results were reversed. Among nonrespondents, better income was associated with unfavorable health. Poor health was generally more common among nonrespondents than respondents in several subgroups. Conclusion: Differences in response rates were found in sociodemographic factors, health, and socioeconomic position. Favorable health was generally more frequent among respondents than nonrespondents. In particular, health inequalities by gender and income differed between respondents and nonrespondents. Thus, nonresponse may lead to bias in analyses of health inequalities among aging people. © 2011 Elsevier Inc. All rights reserved.


Mahler M.,Nordic School of Public Health | Sarvimaki A.,Age Institute
Scandinavian Journal of Caring Sciences | Year: 2012

Fear of falling is a well-known condition in later life. The aim of this study was to illuminate the experiences and the meaning of fear of falling in a daily-life context. The method used was a qualitative study inspired by interpretive phenomenology. In narrative interviews, five community-dwelling women over 80years of age told about their fear of falling from a daily-life perspective. The overall thematic analysis resulted in three main themes: the meaning of managing daily life necessities; keeping in contact with the outside; living with fear. The findings showed that to live with fear of falling was to discipline daily life, and to learn to live with the challenge of a vulnerable bodily condition and of losing control at different levels: from falling, from incontinence, from dirt and from the stigma of being in a humiliating situation. The women created a perception of independence while they were dependent on help and community care and on news from the outside. At an existential level, they coped with their fear by strengthening their will. The conclusion was that the older women studied accepted the condition of fear of falling. They shared the ability to cope in various ways with the limitations of their bodily capacity and their imbalance. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

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