Valorización del proyecto

People experience many roles throughout the course of their lives. These roles are often associated with a distinct identity. Roles guide people in their behaviour and

serve as a source of personal self. In essence, people construct self within roles, structured by a sequence of chronological events and changes within their self-image (Kammerman, 1988). Sequenced elements such as coping with life in Parkview, abandonment of many previous roles after moving there, a gradual decline in functional ability and an increase in frailty result in a role change in the life of residents. Residents need to have satisfying roles in their daily lives in order to feel meaningful and useful (Smyntek, 1997). Without this role identification, residents lose their personal self. Living in residential care thus brings additional threats to self (Bickerstaff & McCabe, 2003).

The desire for preservation of self is obvious in residents‟ conversations. King emphasised that,

it is important to state my feelings out loud, and to say how I feel, to say, “I am angry”. I am stating that the feeling is who I am. By stating the feeling out loud, I am affirming that I have a right to feelings and to my own voice. I own my right to speak up. (King)

As written in my case notes about Chan King:

King had strong likes and dislikes, particularly in matters pertaining to her personal life. She maintains strong opinions about things that go on around her. King has a strong sense of self. When Susan, her daughter, asked her reason for purchasing a wash board, King asked her to stop asking, saying it was not her business. “I am the mum, not you.” Susan said that King was quite assertive and always insisted on behaving in her own way. (field note)

King projected a sense of self-esteem and belief in her competence by making a contribution to her own everyday activity. She disregarded the routine and health reminders from the staff. Having a strong sense of “self” as a whole, King insisted on individuating her personal choice and characteristics. Maintaining her past habits, King wanted to ensure full autonomy over every tiny aspect of her life. (field note)

Most of the residents participating in the study had been relatively independent before moving into Parkview, and therefore they experienced not only a sense of being institutionalised but also “a loss of self”. Maintaining past habits and an individual routine is associated with strong preservation of self. These residents discussed their

loss of control, abandonment of previous roles, sense of powerlessness and difficulty in preserving their “self”. The residents struggled with asserting their personal preferences, maintaining their self-care independence and their roles as parents, grandparents and residents in Parkview. For instance, King notes:

I can never accept something like this. I am not so old and have always been pretty healthy. I don‟t like to follow their routine. I can manage to do the things on my own. I am not so old. I like to take a bath before going to bed, I have my personal routine. (King)

As King and some other residents suggested, the idea of being strong and independent, protecting the self and their independence, was characteristic of a distinct personality trait for them. This identity is unavoidably transformed by moving into a facility and the need to follow its routine (Anderberg & Berglund, 2010). Life in a residential facility thus creates a sense of loss of self that stands in extreme opposition to their former independent identity. Being self-reliant, the residents in the resident-driven triad readily identified with being involved in their own daily life and their own care rather than being cared for and following rules.

Another profound characteristic of the preservation of self is the creation of a life story or parts of it, often associated with residents‟ life events. Through recounting their stories about their life, past and present, residents presented who they are, based on their selective memories, their life events and factual accounts of their past, linking them together sensibly and then placed in relation to the present context of living in a residential facility. For King this means the following:

I ran a Chinese knotting interest group in the past, making Chinese knots. And er… that was interesting, „cos the production of Chinese knots went through the process of “waving”, “pulling”, “correcting”. Each method is fixed but pulling decides its tightness, wing length, and fluency and tidiness of ropes, which shows my skill. Behind the time and effort it takes, its underlying meaning is purity, nature and skilful hands that cannot be replaced by machine…. . I began to teach Sum and Kam Chi and continue with the workshop here. (King)

King had a very strong notion of being someone who carried on with her past hobby and routine in the present. Running the workshop allowed King to lead a group and align herself with the staff supporting her, such as Helen, to feel respect, useful and needed.

The relationship with their children provided recognition, attachment and positive regard, which the theoretical literature suggests are vital for the preservation of self (Branaman, 1997; Goffman, 1997). Being a parent and grandparent and taking great pride and pleasure in the successes of their children was important, as they frequently recounted stories of their children‟s successes in life.

Kam Chi discussed how she saw herself as occupying a central role as a loved and cherished member of her family. Being a wife, a mother and a grandmother and taking great pride and pleasure in the successes of her children and grandchildren, she frequently recounted stories of her children‟s successes in life.

Mm. They‟re good, good girls, you know, my daughters, and my sons-in-law. Well, I suppose I don‟t…, I‟m not boasting about them at all, but it‟s partly the way I bring them up, isn‟t it? Do you agree? (Kam Chi)

These stories provided the basis for preserving the self. A heightened consciousness of self is obvious in the resident-driven care triad in which the residents take responsibility for protecting and taking care of themselves. King notes:

I need to tell them (my daughter and staff) when they are acting in ways that are not acceptable to me. A first step is them starting to know that I have a right to protect and defend myself. That I not only have the right, but a duty to take responsibility for how I allow them to treat me. (King)

The residents focused on the way in which they carried themselves, moved and acted on their own terms, while appreciating their life-long habits of going about their everyday practices and activities. Buber (1970) asserted that the preservation of self is significantly related to the recognition of status and quality of interpersonal relationships. Kitwood and Bredin (1992) and Kitwood (1997) also argued that the concept of self was not a property of a person, but a status that was bestowed upon

one person by others in a relationship. The resident‟s individual attributes dominate the resident-driven triad.

A heightened consciousness of self and identity is not just limited to the residents, but extends to family members as well. While for the resident such self-consciousness is mostly dependent on an individual possessing certain personality traits, for family members it is initiated by a change in how the family view themselves and new identity formations based on a change of roles. Many families do not lose their sense of commitment and demand to be involved in providing support and care to their relatives in a way that impinges on the family-driven triad.