Life trajectories in old old age: Swiss Interdisciplinary Longitudinal Study on Old-Old-SWILSO-O

Ref. 5813

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Suisse Romande (Genève et Valais Central)


One striking feature of demographic change is the growth, both absolute and relative, in the number of the very old (80 and over). Of the one million old people in Switzerland today (who make up 15 per cent of the population), one in four is over 80. Roughly one out of every two of these needs help to carry out one or more basic activities of daily life. In order to deal with this changing demographic and social situation, a whole institutional structure is being put in place, entailing for its operation the application of criteria and definitions. This interdisciplinary research project focuses on: 1. The transition from old to old old age, the latter being characterized by impaired independence (because of a physical handicap) and/or autonomy (in the case of a mental handicap) and hence dependence on others in performing vital everyday activities; 2. Current work on the construction and standardization of the last stages of life in old old age. The first aim is to identify the individual and environmental factors and processes that are conducive to the old person's autonomy, physical and mental integrity, and participation in society; conversely, it is also to pinpoint the factors and processes that impair or diminish the person's autonomy, integrity and ability to participate (subprojects 1 and 2). The second aim is to analyse the measures taken to support and comfort old people through each phase and to evaluate their impact, pointing out clearly the criteria and indicators applied (subprojects 1 & 2). The third aim is to clarify the extent to which a normative model of old old age and the end of life is taking shape, and to analyse the criteria and markers of the transitions and stages in this final phase of the life course (subproject 1). The fourth aim is to make an economic assessment of health consumption and see how it evolves in advanced old age, then to compare individuals' costs and trajectories (subproject 3). The fifth and last aim is to identify and carry out a cross-disciplinary ethical evaluation of issues and decisions with their implications, taking into account the norm of respect for the person's autonomy, the principle of responsibility, and real-life situations. This subproject 4 is planed for a second stage of the Program (2000-2003). As far as methodology is concerned, trajectory studies require a longitudinal approach. We therefore consider at time t1 a sample of the cohort of 80 to 84-year-olds living at home; the subjects are interviewed once a year. As old old age has become a rapidly changing subject of study, it is essential to allow for the likely impact of cohort effects and therefore to base the study on two five-year cohorts separated by an interval of five years. This will bring to light the effects peculiar to each cohort, associated with changes in the sociohistorical context, as well as invariants and variations between individuals. Swilso-o builds on an earlier project launched under NRP32 (Old age), which it will prolong and enrich by going into more detail. It is its continuation, development (second cohort), enrichment (of psychosocial as well as network analysis aspects) and renewal (introducing economic approach). Structurally, this project will mobilize the efforts of nine units from two universities and will reinforce the position of the Centre for Interdisciplinary Gerontology (the only one of its kind in Switzerland) as a centre of expertise, as well as strengthening its interdisciplinary and interinstitutional network. With regard to funding, the project is envisaged as a joint venture between SNSF and the local authorities of the cantons most closely concerned, which provide 30% of the global research.