Polacsek, Meg (2018) Self-empowering to maintain and enhance personal identity as an older adult with depression. PhD thesis, Victoria University.

Abstract

Australians have one of the longest life expectancies in the world, but up to 15% of older Australians living at home experience depression. Increasing attention is being paid to understanding the clinical aspects of depression in older age. However, less is known about how older Australians living in the community experience and self-manage depression, and the factors that influence these processes. The purpose of this qualitative grounded theory study was to explicate the self-management strategies used by older adults diagnosed with depression to optimise their well-being. Data collection and analysis were informed by Corbin and Strauss’ (2015) approach to grounded theory. Data were collected through 32 individual interviews, observations and questionnaires. The key conceptual findings of the study comprise a core problem, a core category and three related categories. The basic social psychological problem was conceptualised as Struggling to maintain personal identity as an older adult with depression. The core category, Self-empowering to maintain and enhance personal identity as an older adult with depression, was abstracted through simultaneous data collection and analysis, and constant comparison. This goal was achieved through the three interlinked strategies of Taking Stock, Accessing Support and Reclaiming Self-identity. Participants’ efforts were influenced by three contextual determinants: Perspectives on age and depression influencing help-seeking, Ability to navigate and access the health care system, and Individual capacity for self-management. When drawn together, these elements comprise a substantive theory that reflects a shift from a narrow biomedical discourse of depression in older age to a broader experiential focus on individuals as experts for managing long-term conditions. The findings of this study have implications relating to policy, professional practice, the portrayal of age and depression, older adults and their significant others, and future research.

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