Exploring the use of assistive aids in later life : a narrative analysis with older people and occupational therapists : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Auckland, New Zealand

Abstract

Assistive aids (AA) are increasingly used by older people to support autonomy and improve quality of life. Despite their functional benefits, adoption is often accompanied by complex psychosocial challenges, including experiences of stigma and ageism, which can fuel resistance to adopting AA. This study explores how older people make sense of and negotiate the use of these devices in daily life, and how occupational therapists (OTs) involved in AA prescription understand the process older people go through when adopting AA. Qualitative data was collected from two sources: in-depth semi-structured narrative interviews with seven older people considering or beginning to use AA and interviews with five OTs involved in the prescription of AA. Narrative analysis was used to understand the experiences of older people and OTs separately, and to examine similarities and differences between user and professional perspectives. Analysing these data sources enabled a contextualised understanding of the social narratives that underpin AA adoption. Four overarching narratives were identified. Older people used two narratives to describe how ageing is shaped by the use of AA: ‘The More You Give up, The Older You Get’, in which older people navigated ageing as something within individual control; and ‘It Makes me Feel Like I’m on the Downward Spiral’ to describe how AA are implicated in the process of decline. Two narratives were used by OTs to make sense of AA use for older people: ‘AA Represents the Ugliness of Ageing’ in which OTs interpreted their clients resistance to AA as loss of independence; and ‘I Hear From Almost Every Client I See, I Just Want to Stay in My Own Home’ in which OTs described the shared goal they had with their clients: for older people to remain in their homes. The analysis explored points of tension and adaptation, such as the emotional and social implications of using AA at home and in community settings, and differences in perspectives between users and professionals. Findings highlighted the barriers and facilitators to acceptance, as well as the complex psychosocial processes involved in integrating AA into daily life. These narratives demonstrate how the adoption of AA in later life is a nuanced process shaped by psychosocial factors beyond physical need. Although older people and OTs describe the process of adopting and adapting to AA in similar ways, this analysis revealed tensions and disjuncture in how AA are experienced in the context of ageing. Understanding and addressing the social and psychological dimensions of AA use is critical for challenging ageist stereotypes and reducing stigma for older people, enabling them to access the mobility and social benefits of AA as they age.