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"You matter because you are you. You matter until the last moment of your life and we will do all we can … to help you LIVE until you die."

—Dame Cicely Saunders


By the end of this chapter, readers will be able to:

  1. Define leisure from an occupational therapy perspective.

  2. Discuss occupational engagement issues related to longevity and age-related disability.

  3. Consider leisure as a statement of identity.

  4. Define three important elements that, when considered collectively, promote total engagement in leisure: control, motivation, and disengagement from unnecessary constraints of reality.

  5. Understand the potential for focusing on leisure, rather than occupational performance components, in occupational therapy intervention.

  6. Identify the role of physical therapy and other disciplines in addressing leisure performance.

Clinical Vignette

Elaine Powers is a 73-year-old "semiretired" geologist. About 4 years ago, Elaine began running as support for her partner, who was training for a marathon. When her partner was injured, Elaine continued running, entering and finishing her first marathon. She has been running ever since and now is ranked as one of the best in her age-group.

  1. What is your reaction to a 73-year-old who takes up running for the first time?

  2. What roles might OT and PT have in supporting her ability to maintain her ability to participate in this activity?

  3. What needs do you think Elaine might be satisfying in participating in this activity?

Longevity and an increase in life expectancy afford humans as occupational beings various opportunities and challenges. With an estimated 30 years added to life, population aging creates a powerful new demographic and social dynamic in 21st-century societies (Kalache, 2013). Alexander Kalache, international ambassador and activist for the rights of older people, explained the practical impact of longevity:

I am now 67 years old. In Australia, I could apply for the age pension. When my grandfather was my age, he carried a walking stick and was shuffling towards his grave. I live a vibrant, active life—I have friends, family and work commitments in different continents and as a result I frequently dash around the planet. My life, like that of so many of the 760 million people in the world over the age of 60, is totally different from that lived by my grandparents. Simply by virtue of the numbers and diversity of people involved, baby boomers are reinventing the experience of ageing. As the global population continues to age, our generation is forcing society to rethink what it means to grow old. (2013, p. 11)

The impact of living longer requires special measures to ensure that older adults experience added years as a time of living well. At a time when active aging is viewed as a right, older people should be enabled to engage in leisure activities that promote health and allow them to remain part of the lives of significant ...

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