The Open Journal of Occupational Therapy

Volume 8 Article 3
Issue 2 Spring 2020

April 2020

Exploring How Older People Living at Home Alone Occupy Their

Time – A Time-Geographic Study
Alison Wicks
University of Canberra - Australia, alison@wicksmail.com

Megan Blanchard
University of Wollongong - Australia, mblancha@uow.edu.au

Ingeborg Nilsson
Umea University - Sweden, ingeborg.nilsson@umu.se

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Part of the Occupational Therapy Commons

Recommended Citation
Wicks, A., Blanchard, M., & Nilsson, I. (2020). Exploring How Older People Living at Home Alone Occupy
Their Time – A Time-Geographic Study. The Open Journal of Occupational Therapy, 8(2), 1-7.
https://doi.org/10.15453/2168-6408.1625

This document has been accepted for inclusion in The Open Journal of Occupational Therapy by the editors. Free,
open access is provided by ScholarWorks at WMU. For more information, please contact wmu-
scholarworks@wmich.edu.
Exploring How Older People Living at Home Alone Occupy Their Time – A Time-
Geographic Study

Abstract
Background: Knowing what older people choose to do with their time informs occupational therapists in
their everyday practice. This study explored how sixteen older Australians living at home alone without
support occupied their time.

Method: People aged 70 years and older living alone in one’s home and receiving no support services
were voluntary recruited. The participants completed time-use diaries for 5 days and recorded how, with
whom, and where they spent time. Data were coded and analyzed using the software program Vardagen.

Results: The participants reported 217 different daily activities. While patterns of daily participation
varied, all of the participants spent some time with others and some time away from but near home. The
majority of their time was spent alone. On average, the participants reported meaningfulness in their
occupations 90% of the days.

Conclusion: The study highlighted how older people living at home without support services can
meaningfully occupy their time if they have access to personally relevant people and places.

Keywords
daily activities, occupations, participation, time use

Cover Page Footnote

This study was financially supported by The Swedish Foundation for International Cooperation in
Research and Higher Education; the Swedish Research Council’s Linnaeus Grant, no.
2006-21576-36119-66; and the Shoalhaven Campus, University of Wollongong.

Copyright transfer agreements are not obtained by The Open Journal of Occupational Therapy
(OJOT). Reprint permission for this Applied Research should be obtained from the
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and distribution of this Applied Research.
DOI: 10.15453/2168-6408.1625

This applied research is available in The Open Journal of Occupational Therapy: https://scholarworks.wmich.edu/
ojot/vol8/iss2/3
 Older people home alone

Participation in different activities and being a resource to families, communities, and

economies are both recognized as important for healthy aging (World Health Organization, 2019)
and are important considerations for occupational therapists working with older people. However,
discussions about aging well often ignore the role of home-based activities and personal daily habits
in maintaining older people’s life satisfaction and well-being, and the topic is not found in
occupational therapy research on promoting and maintaining the health of older people. Moreover,
despite proposals for a salutogenic approach to health (Becker et al., 2010), most studies in
gerontology focus on people with impairments who need support, while there are few studies on
those older people who are managing to live independently without support services. This study,
which is underpinned by an ecological model of health (Filiatrault et al., 2015) and undertaken by
occupational therapists working in the field of health promotion, addresses these gaps identified in
research on aging by providing insight into how older people who are living at home alone without
support services occupy their time. Knowing what older people living independently choose to do
with their time can help inform occupational therapists and other health care practitioners who
provide services for the elderly, thus ensuring they best meet the needs of clients living at home
alone. Such knowledge is essential for the provision of customer directed care, which is becoming
increasingly common in domiciliary and community-based aged services, especially in countries
such as Australia, the United States, the United Kingdom, and New Zealand (Ottmann et al., 2013).
Practitioners can also apply understanding about effective strategies that enable older people to age
well when working with health programs or with older people in aged care facilities.
This study replicated an occupational science research project undertaken in Umea in
northern Sweden. It is the first known project to adopt a time-geographic approach with older people
as participants (Nilsson et al., 2015). Occupational science was established in 1989 by occupational
therapists to generate knowledge about occupation, the core domain of occupational therapists, and
to understand the relationship between occupation and health (Zemke & Clark, 1996). Occupational
science is an important knowledge source for occupational therapists and informs their clinical
reasoning (Kristensen & Schultz Petersen, 2016) as it explores how geophysical, socio-cultural,
economic, and political contexts shape what people do (Whiteford et al., 2005). In occupational
therapy and occupational science, the daily activities in which a person participates, the things they
do, are conceptualized as occupations (Hocking, 2009). Occupations encompass everything people
do as individuals in families and in communities to occupy time and to bring purpose and meaning to
life (Christiansen & Townsend, 2010). Occupational scientists adopt an occupational perspective in
their research and maintain that humans are occupational beings who need personally meaningful
occupations for health and well-being. An occupational perspective is “a way of looking at and
thinking about human doing” (Njelesani et al., 2014, p. 226).
Time-use studies of healthy older people have demonstrated that the majority of their time is
spent indoors performing occupations such as resting or sleeping (Cha, 2018; Punyakaew et al.,
2019) and alone (Punyakaew et al., 2019). It is interesting that it has been shown that satisfaction
with life seems to increase with the amount of time spent in leisure activities and outdoors (Cha,
2018). In addition, an increased time spent in social participation was associated with less sedentary
time, which could have potential health benefits (Kikuchi et al., 2017). Gender, as well as
disadvantages associated with lower socio-economic levels, have been shown to influence patterns of
occupational involvement (Punyakaew et al., 2019; Sabbath et al., 2016), indicating that time use of
older people is influenced by various factors. Occupational temporality, when time and space are
integrated (Zemke, 2004), could give insights into the occupational needs of older people (Nilsson et
al., 2015), which, in turn, could enhance the development of health programs for older people.

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The rationale for this study was that adopting an occupational perspective while investigating
the ordinary, everyday activities older people choose to do while living at home will increase
understanding of the relationship between aging, context, and doing. Therefore, by application of a
time-geographic perspective, this study aims to explore the daily occupations of older people who
live alone in their homes without support services. The findings will interest and inform health
professionals working with older people who are either living in their own homes or who are living
in aged care facilities.
Method
Design
We adopted a time-geographic approach (Ellegård, 1999) to gather information about the
time component and context of the daily occupations of older people living at home alone, as this
approach aligns well with an occupational perspective of health. Vardagen, a Swedish word meaning
everyday life, was the time-geographic software program selected for this study (Ellegård, 2009).
Human geographers developed the Vardagen program in Sweden in the 1990s, and it has since
undergone further development that has occurred in cooperation with Swedish occupational
therapists. Since its development, the program has been used by researchers in various fields, mainly
human geography, technology, social work, and occupational therapy (Bendixen & Ellegård, 2014;
Nilsson et al., 2015; Orban et al., 2012) to explore areas such as living in urban areas and the use of
mobile information and communication technologies (ICTs) in everyday life (Ellegård, 2019).
Participants
Older people living in the Shoalhaven on the south coast of New South Wales, Australia,
were recruited to this study, which was approved by the ethical board at the University of
Wollongong. The criteria for voluntary participation in the study were: at least 70 years of age, living
alone in one’s own or rented home in Shoalhaven, and receiving no support services. The Research
on Humans Ethics Committee at the University of Wollongong approved the study, and it was
undertaken in accordance with all required ethical standards.
Sixteen participants (four men and 12 women, aged 71 to 84 years) provided informed
consent. Twelve of the participants were living in a house, two were living in an apartment, and one
was living in a granny flat, a small apartment attached to the home of a family member. At the time
of the study, the participants were all living alone and self-reported as being well. No one was
receiving any support or home care services.
Procedure
The means of recruitment were local media, local organizations, and word of mouth.
Potential participants attended a workshop conducted at the Shoalhaven Campus of the University of
Wollongong for training and instructions in the use of Vardagen time-use diaries. Others who were
interested but could not attend the workshops were given individual instructions in their own homes.
The participants were then asked to complete a hand-written, open diary for 5 days. They
could choose any 5 days in a 2-month period (January to February) but were requested to include
weekends and weekdays and to select days considered normal or usual. An open diary format was
selected, as it enabled the participants to self-define their occupations (Chilvers et al., 2010). As well
as recording when and for how long they engaged in their daily occupations, the participants
recorded where the occupations occurred (at home, close to home, more than 300 m from home, in
another city or country) and with whom (with a friend, with family, or with others). In addition, the
participants were asked to record the meaningfulness of their daily occupations by using a scale from
1 to 5; 1 = very important, 2 = important, 3 = neither meaningful nor unmeaningful, 4 = not

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 Older people home alone

meaningful, and 5 = waste of time. It was explained to the participants that a meaningful occupation
refers to doing something that has personal importance or particular meaning (Fisher, 2009).
Data Analysis
We selected Vardagen for data analysis because it can be used to describe and analyze an
individual’s daily life as it is presented in a time-use diary. One interesting feature of Vardagen is its
flexibility, as the time-use diaries can be customized based on a particular study’s aims. Vardagen
can also capture the meaningfulness (i.e., the personal importance of daily occupations) as rated by
the participant and the extent of daily social connections (Ellegård, 2009; Nilsson et al., 2015). Such
occupational features have particular relevance for occupational therapists, whose role is to enable
people to participate in the occupations of everyday life; to do the things they need and want to do as
individuals, with families and in communities; and to occupy time and bring meaning and purpose to
life (World Federation of Occupational Therapists, 2019).
The Vardagen program is based on a specially formulated categorization scheme that
contains the codes that fit the program. It is also possible to add one’s own codes. In its basic form,
the program can be used to visualize activities, geographical mobility and social contexts, and to
calculate the average time expenditures for activities, stays in locations, and social situations
(Ellegård, 1999).
Sixteen diaries were submitted for analysis, but one was excluded because the participant had
not followed the instructions and neglected to include the time spent on each recorded occupation.
All other reported daily occupations were coded according to categories and levels specified in
Vardagen; for example, 003 eating breakfast, 027 getting dressed after sleep, 247 helping with
homework, 314 knitting, and 666 harvesting vegetables. All coded data were entered into the
software program for analysis. To ensure consistency in coding, a research assistance trained and
supervised by the first author entered all codes. Using the software program, we developed frequency
tables and graphs for each participant. For descriptive analysis of the occupational engagement of the
participants as a whole group, all time frequencies were exported to Excel.
Results
There was a wide variety in the reported daily occupations recorded by the 15 people over 5
days. Included in the 217 daily occupations recorded were: reading the bible, feeding and talking to
the caged pet bird, tending the grave site of a spouse, and driving grandchildren to after-school
activities. In addition, each person’s daily pattern of participation in occupations, as described in the
diaries, was unique. For example, some of the participants followed the same routine each day
whereas others had less conformity in their occupational patterns.
Figure 1 shows the percentage of time the participants spent with other people over the 5
days. All of the participants spent the majority of their time alone with an average of 84% of their
time spent alone.
Although most of the participants’ time was spent alone, on average 50% of their recorded
days included at least a small amount of time with friends, with three participants spending part of
every day with friends. Approximately 30% of the recorded days included time spent with family,
and two participants spent part of every day with family. In addition, about 40% of the recorded days
included time spent with others or at groups and organizations. All of the participants spent at least
part of every day alone. The men spent more time alone each day than the women. All of the
participants spent at least part of one day away from home at places such as the golf course, the
shopping center, and the hospital. Only one slept away from home during the 5 day periods.

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Figure 1
Reported time spent alone and with family, friends, or others
100

80
Proportion of time

60
Other
40 Family
A friend

20 Alone

0
F M F M M M F F F F F F F F F
1 2 3 4 5 7 8 9 10 11 12 13 14 15 16
Person/Gender

Figure 2 shows the reported meaningfulness of all of the participants’ occupations over the 5
days. The most common rating used by all of the participants over the 5 days was important, used on
average on 90% of the days.

Figure 2
Reported meaningfulness of daily occupations: a waste of time; not meaningful; neither nor;
important; very important
100

80
Proportion of time

60
Very important
Important
40
Neither nor
Not meaningful
20 A waste of time

0
F M F M M M F F F F F F F F F
1 2 3 4 5 7 8 9 10 11 12 13 14 15 16
Person/Gender

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 Older people home alone

For participant 13, an 85-year-old female, a meaningful occupation was speaking on the
phone to her cousin in London. Only three people recorded participating in occupations considered
to be a waste of time. For participant 13, trying to start the mower was a waste of time, while for
participant 4, a 77-year-old male, attending the home of his partner’s son for a late Christmas
gathering was a waste of time because he felt everything was so false and wasteful. Only four people
recorded participating in nonmeaningful activities. Participant 11, an 80-year-old female, recorded
that spending time trying to solve a problem with her computer was nonmeaningful.
Discussion
The time-geographic approach adopted for this study provided data on where, for how long,
and with whom a small sample of older Shoalhaven people chose to occupy their time in a personally
meaningful way. As such, the study offered a window through which to view the everyday
experience of day-to-day life, which is often seen but not noticed or appreciated by others
(Hasselkus, 2011). The findings give a snapshot of the daily occupations of older people who live
alone in their homes without support services. This snapshot cannot be generalized because of the
study’s limitations, which include difficulty in recruiting older people who are not actively engaged;
the study’s relatively small sample; and the nonreporting of occupations that the participants
seemingly take for granted, e.g., having a shower or bath, eating breakfast, going to bed. However,
despite the limitations, there are some implications arising from the study for occupational scientists;
occupational therapists; and other service providers in the aged care industry, such as activity
officers.
From an occupational perspective, the wide range of occupations that were reported
demonstrates the nonhomogeneity of older people. Given the relationship between engagement in
meaningful occupation and well-being (Wilcock, 2006) and the individualized nature of meaning
(Fisher, 2009; Hasselkus, 2011), this particular finding means that once older people living at home
require support, then flexible and client-centred services are needed to accommodate their diverse
occupational interests and needs.
The high level of meaningfulness of the participants’ chosen daily occupations highlights the
importance of home-based daily habits for older people’s sense of purpose. As older people living
alone find meaning in spending time with family and friends, support to facilitate access to family
and friends is also important. As social participation contributes to healthy aging (Kikuchi et al.,
2017; Larsson et al., 2016; Nilsson et al., 2018) community-based services to create opportunities for
engagement with others may decrease the risk of loneliness among older people.
There are some practical implications arising from this study that are relevant for
occupational therapists working with older people. First, living at home alone is more frequently on
the public radar. Throughout the Western world, the number of one person households is increasing
and the trend is spreading in non-Western countries (De Vaus & Qu, 2015). Second, for those older
people who make the transition to residential aged care facilities, it is apparent from this study that it
is important they have opportunities and choices to satisfy their individual interests. And third,
programs that are client-centered are necessary, given the trend to consumer directed care
(http://mcarthur.com.au/media/1428/understanding-cdc-a-simple-definition.pdf). While group
activities may satisfy residents’ needs for social interaction and physical excursion, it seems older
people still need to be able to do what they need, want, and are expected to do.
In addition, the study highlighted the importance of participation in daily occupations for
sustaining active and healthy aging and reinforced Wright St. Clair’s (2012) finding that the value of
the minutiae of daily life increases as people age, particularly for people living alone. Given that
people are living longer and that there is an increasing number of people living alone, at least in

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Western societies such as Australia and the United States (de Vaus & Qu, 2015), it is important to
appreciate that older people living at home alone, with or without support, or in residential facilities
need to experience the minutiae. Daily routines are personally meaningful. Therefore, it is important
that older people continue to do these routine activities for themselves, rather than for someone else
do them for them.
In relation to implications for research, gender differences in time use among older people
living at home with or without support could be explored. Moreover, similar studies could be
undertaken in other countries to help understand the role of geophysical and socio-cultural contexts
in enabling older people living at home alone to participate in various meaningful occupations.
Finally, other time-use studies exploring the form, function, and meaning of everyday doing of
people of all ages could highlight potential infrastructure development in society to address
occupational needs (Njelesani et al., 2014).
Conclusion
Time-use studies such as this one that involve diaries completed by older people living at
home alone and without support services can capture older people’s patterns of participation in daily
occupations, thereby providing insight into some strategies that are facilitating their active aging.
Despite acknowledged limitations, the study has shown that living at home provides older people
opportunity to maintain personally meaningful routines and daily habits. Health care professionals
should prioritize ensuring that older people living at home alone can continue to maintain their
routines and habits once they require support services.

Alison Wicks is an adjunct associated professor in occupational therapy, Faculty of Health at the University of
Canberra, Australia
Megan B. Blanchard is a research fellow in applied statistics at the Australian Health Services Research Institute,
University of Wollongong, Faculty of Business, Australia
Ingeborg Nilsson is a professor in occupational therapy, Umeå University, Community Medicine and Rehabilitation,
Sweden

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