Staying in ‘the stream of life’: rehabilitation of older people in their own homes following total hip replacement

Abstract

Background. According to World Health Organization (WHO), rehabilitation should be based on the person's entire situation with a focus on body functions, level of activity, participation and environment. But different types of investigations show an unclear concept of rehabilitation in professional nursing. Aims and objectives. This study aims to identify older persons' (≥75 years of age) experiences of the rehabilitation process after total hip replacement. Design and methods. Qualitative interviews were undertaken with six persons who were rehabilitated in their own homes following total hip replacement. The interviews were guided by Max van Manen's phenomenological methodology with its focus on the life world as described through patients' experience of time, space, body and interpersonal relations. Results. Staying in the stream of life confirmed the importance of the life world. What is essential in the rehabilitation process is to get back into everyday life as soon as possible and participate in activities which are meaningful and which are linked to being at home where 'you can be who you are'. The home is the framework for being in the stream of life, and it provides the centre of gravity for the people's welfare. Conclusion. Staying in the stream of life is about being the author of one's own meaningful life. It takes into account life phenomena embodied in the maintenance aspect of health care; dignity in relation to identity and integrity; and an understanding of the dialectical relation between frailty and strength. Relevance to clinical practice. Rather than focusing exclusively on patient participation and goal-directed activity, nursing actions should integrate life phenomena as key aspects of rehabilitation with older people in their own right.