An exploration of autonomy and independence among community dwelling people aged 85 and over

Abstract
The number of adults aged over 85 years in our society is increasing, and many of these people, contrary to common stereotypes, enjoy relatively good health and live independent lives. This independence was achieved despite the negative thinking about ageing that colours our social landscape. A qualitative study was designed to describe the views of five adults, aged 85 or over regarding how they expressed and negotiated independence and autonomy in their daily lives, and when in contact with the health care system. Additionally, the study aimed to provide healthcare professionals with information regarding independence, autonomy and decision-making when caring for older adults. Using qualitative description as a research design, the data were generated by face-to-face interviews with one man and four women and then analysed by the general inductive approach towards data analysis described by Thomas (2006). The findings were grouped into three themes: independence, past and present; autonomy and decision-making; and health. The overall picture was one of older adults using resourcefulness and determination to organise their lives and maintain independence. Obtaining support and assistance in various forms was an important element for achieving these goals. Positive, as well as negative, experiences were described by participants in their contact with health care professionals and advice offered to those professionals include themes of listening carefully to patients and of communicating in a genuine manner. This study provides evidence of older adults living selfdetermined lives. It points to the need for nurses and other health care professionals to carefully guard respect for the personhood and autonomy of their oldest clients.

Ngā ariā matua
Kei te piki haere te tokomaha o te hanga pakeke i tō tātou hapori kei runga ake i te 85 tau, ā, kei te pai te hauora, kei te noho tonu te tini noa o ēnei tāngata i runga i te mana motuhake, ahakoa ngā pōhēhētanga a te marea mō tēnei mea te kaumātua. Kua eke ki tēnei āhua o te noho motuhake ahakoa ngā whakaaro whakahoki tupu mō te kaumātuatanga e noho nei hei weri i roto i te ao o tauiwi. I hoahoatia tētahi rangahau ā-kounga hei whakamārama i ngā whakaaro o ētahi pakeke, kua eke nei ngā tau ki te 85 tau piki ake, mō te āhua o tā rātou noho ko rātou anō hei mana motuhake mō rātou anō, me tō rātou noho pakari takitahi i ia rā, i ia rā, ina whakapā atu hoki ki te pūnaha hauora. Waihoki, i whai anō te rangahau ki te hura mōhiotanga mā te hunga hauora ngaio mō te mana motuhake, te noho pakari takitahi me te whakatau tikanga ina tiaki te tangata i te kaumātua, he maha ō rātou raumati i tēnei ao. Ko te hoahoa i whakamahia ko te whakamārama i te kounga, ā, i hua ake ngā raraunga mai i ngā uiuinga ā-kanohi ki tētahi tāne, ki ētahi wāhine tokowhā hoki, kātahi ka tātaritia i raro i ngā tikanga tātari raraunga toro-whānui. I whakarōpūtia ngā kitenga kia toru ngā ia: Mana motuhake, o mua, o nāianei; te noho pakari takitahi me te whakatau tikanga; me te hauora. Ko te whakaahua whānui ia, he kaumātua ēnei e whakamomori ana, ahakoa te kore rawa tōtika i ētahi wā, e whakamanawanui ana hoki ki te whakarite tikanga mō rātou ia rā, kia puritia hoki tō rātou mana motuhake. Ko te whātoro atu ki te hunga tautoko, me te āwhina mō ngā mea huhua tētahi wāhi nui o te ekenga ki tēnei taumata. I whakamāramatia ētahi wheako papai, ētahi kāore i pai, e te hunga whakauru mai, mō ā rātou noho tahitanga ki ngā mātanga hauora ngaio, ā, ko ētahi o ngā tohutohu ki te hunga ngaio kia kaua e wareware ki te āta whakaaro ki ngā tūroro, kia whakawhiti kōrero hoki i runga i te ngākau pono. Ka kitea kei tēnei rangahau ētahi kōrero mō ngā pakeke kaumātua e noho ana i runga i tō rātou mana motuhake; ka kitea i roto te whāinga tino nui, kia kaha ngā tapuhi me ngā mātanga hauora ngaio ki te tiaki i te mana tangata me te mana motuhake o ō rātou kiritaki tino kaumātua rawa.

Keywords / Ngā kupu matua
Older adults/Ngā kaumātua; autonomy/pakari tū takitahi; independence/mana motuhake; successful ageing/ te kaumātua
haere i roto i te toiora; healthcare/ te manaakitanga hauora