Journal of Occupational Science

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Occupational balance as described by older

workers over the age of 65

Pia Hovbrandt, Gunilla Carlsson, Kerstin Nilsson, Maria Albin & Carita
Håkansson

To cite this article: Pia Hovbrandt, Gunilla Carlsson, Kerstin Nilsson, Maria Albin & Carita
Håkansson (2019) Occupational balance as described by older workers over the age of 65, Journal
of Occupational Science, 26:1, 40-52, DOI: 10.1080/14427591.2018.1542616

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JOURNAL OF OCCUPATIONAL SCIENCE
2019, VOL. 26, NO. 1, 40–52
https://doi.org/10.1080/14427591.2018.1542616

Occupational balance as described by older workers over the age

of 65
Pia Hovbrandt a,b, Gunilla Carlsson b
, Kerstin Nilsson a
, Maria Albin a,c
&
Carita Håkansson a
a
Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University,
Sweden; bDepartment of Health Sciences, Lund University, Sweden; cUnit of Occupational Medicine, Institute for
Environmental Medicine, Karolinska Institute, Sweden

ABSTRACT ARTICLE HISTORY

Occupational balance promotes health, knowledge about occupational Accepted 17 October 2018
balance among older workers is important. This qualitative study aimed
to describe occupational balance among older workers in Sweden. Six KEYWORDS
Occupational science; Active
focus groups and two individual interviews were conducted with 26 ageing; Ageism; Older
workers, aged 65 years and older. The findings showed that drawing on workers; Occupational
abilities and resources, a harmonious mix of occupations, as well as balance; Productivity
congruence with values and personal meaning contributed to the
participants’ occupational balance. From a work perspective,
organizational factors such as support from managers and having the
freedom to influence work tasks, as well as work time, also contributed
to occupational balance. The participants changed their occupational
pattern to achieve a more harmonious mix of occupations. This change
was based on values and experience derived through the meaning of
occupations, and on abilities and resources. Enabling older people to
achieve occupational balance and promoting health may contribute to
possibilities for an extended working life and active ageing.

Work is the predominant occupation of adults
aged between 18-65 years in many high-income
countries. With population ageing putting
increasing pressure on the welfare and pension
systems, an extended working life is of vital con-
cern (EU-OSHA, Cedefop, Eurofound, & EIGE,
2017). To support economic growth, national
policies increasingly aim at keeping older people
in the workforce; a prerequisite for which is that
individuals feel that working more years will
support a good life, including promoting health
and well-being. Being employed is known to
contribute structure and regularity in everyday
life, as well as generating income and promoting
independence (Wolverson & Hunt, 2015). It also
contributes to development, personal identity,
and self-fulfillment amongst adult and older
workers (Hovbrandt, Håkansson, Albin, Carls-
son, & Nilsson, 2017; Jahoda, 1981). Work is
also considered to have potential to influence
health and well-being (Chalofsky, 2003; Has-
selkus, 2011; Yerxa, 1998). For example,
among older men positive relationships between
health and a longer working life have been
reported (Hoglund, Sadovsky, & Classie, 2009),
such as better self-rated health and lower mor-
tality (Luoh & Herzog, 2002) and better mental
health (Hao, 2008).
Conversely, one of the most important factors
for managing work is health (Nilsson, 2016, 2017;
Nilsson, Östergren, Kadefors, & Albin, 2016).
Research indicates that well-educated people

CONTACT Pia Hovbrandt pia.hovbrandt@med.lu.se

© 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
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original work is properly cited, and is not altered, transformed, or built upon in any way.

and those with good health have the best oppor-
tunities for an extended working life (Hofäcker &
Naumann, 2015), but the improvement in life-
expectancy and self-reported health attributed
to working is lower among those with less edu-
cation or low income (Lundberg, 2017). Research
has also identified that work-related factors are a
potential source of stress and ill-health that force
people into early retirement in Europe (EU-
OSHA et al., 2017). Regarding stress, previous
research shows that balance between different
occupations in daily life positively affects the
risk for stress-related disorders (Håkansson &
Ahlborg Jr, 2018). Thus, stress-related disorders
are related to both working conditions and occu-
pational balance, and have to be considered when
focusing on a sustainable working life.
While work can be an important and mean-
ingful occupation for older people, their partici-
pation in the workforce may be limited by
barriers beyond their control, with resultant
occupational deprivation (Hocking, 2012;
Whiteford, 1997). Barriers described in previous
research include lack of support from managers
and colleagues, physical as well as psychosocial
demands, and over-emphasis on specific qualifi-
cations (Fraser, McKenna, Turpin, Allen, & Lid-
dle, 2009; Nilsson, 2016), as well as negative and
stereotyped attitudes about older people. Such
barriers may alienate older workers as a possible
resource in the labour market (Harris, Krygs-
man, Waschenko, & Laliberte Rudman, 2017;
Konrad & Jolanta, 2013; Nilsson, 2018), creating
an imbalance between physical, mental and
social occupations, or situations where older
people have too little, or nothing at all to do
(Wilcock & Hocking, 2015).
Occupational Balance and Health
Occupational balance has been defined as a
regular mix of physical, mental, and social occu-
pations; of chosen or obligatory occupations;
and/or strenuous and restful occupations, and
is considered important for health and well-
being (Wilcock et al., 1997). Thus, possibilities
for engagement in valued, necessary, and desired
occupations – for example, work – are impor-
tant. Recent studies provide empirical findings
that support the relationship between occu-
pational balance and health (Håkansson &
JOURNAL OF OCCUPATIONAL SCIENCE 41
Ahlborg Jr, 2010; Håkansson, Björkelund, &
Eklund, 2011; Håkansson, Lissner, Björkelund,
& Sonn, 2009). For example organizational fac-
tors, including support from managers, have
been found to be important for occupational bal-
ance among working parents (Borgh, Eek, Wag-
man, & Håkansson, 2017) and men with
arthritis (Hjalmarsson Österholm, Björk, &
Håkansson, 2013). Among women of working
age, associations have been identified between
occupational balance and experiencing satisfac-
tion with life as a whole and no perceived stress
(Håkansson et al., 2009). In a longitudinal study,
perceptions of occupational balance, low stress,
and meaning in occupations were found to be
predictors of good subjective health for women
(Håkansson & Ahlborg Jr, 2010). Furthermore,
a qualitative study indicated that occupational
balance, which involves respecting personal
values, needs and resources; having strategies
to manage and have control of daily life; and
having a harmonious occupational pattern and
meaningful occupations, was related to well-
being (Håkansson, Dahlin-Ivanoff, & Sonn,
2006). Biological evidence has also been found
that indicates associations between occupational
balance and the immunological/inflammatory
markers, i.e. cytokines and C-reactive protein
(Dür et al., 2016). However, previous research
has mostly focused on occupational balance
among people younger than 65 years of age.
Supplementing the evidence of a relationship
between occupational balance and health,
Eklund and colleagues (2017) have proposed
three indicators for achieving occupational bal-
ance. The first indicator, ‘abilities and resources’
to manage the occupations individuals are
engaged in, reflects the assertion that demands
should not exceed personal and contextual
resources. For example, reduced physical and
mental ability may affect occupational balance
negatively. Abilities and resources for occu-
pational balance also include environmental
opportunities or barriers for occupation; for
example, positive attitudes from managers and
colleagues (Borgh et al., 2017). Moreover, organ-
izational factors such as work arrangements,
working time (Anxo, Ericson, Herbert, & Rönn-
mar, 2017), and redesign of individual work
tasks are related to incentives for working longer
(Prakash et al., 2017; von Bonsdorff et al., 2016).
42 P. HOVBRANDT, G. CARLSSON, K. NILSSON, M. ALBIN & C. HÅKANSSON
Whether these factors are also important to
experiencing occupational balance among older
workers has not yet been investigated.
The second indicator, ‘a harmonious mix of
occupations’, includes the variation and number
of occupations in which individuals engage.
Having neither too many, nor too few, occu-
pations and not being engaged in just one occu-
pation that draws energy from everything else,
were important for experiencing occupational
balance among working adults (Wagman, Björk-
lund, Håkansson, Jacobsson, & Falkmer, 2011).
Managing life, in terms of both paid work and
family life, and participating in a mix of occu-
pations has also been found to be important
for achieving occupational balance (Wada,
Backman, Forwell, Roth, & Ponzett, 2014). A
balance between challenging versus relaxing
occupations, occupations with individual mean-
ing versus occupations that are meaningful in a
social context, and doing things for oneself or
for others, was important for occupational bal-
ance among adults with rheumatoid arthritis
(Stamm et al., 2009). Additionally, a harmonious
mix of occupations includes how compulsory
and pleasurable occupations are, and the phys-
ical, mental, social and restful characteristics of
occupation (Wilcock & Hocking, 2015).
The third indicator for occupational balance
concerns the ‘congruence with values and personal
meaning’ individuals experience in occupation. In
order to achieve occupational balance, people have
been found to change their occupational pattern
based on their experience of meaning and values
in occupations (Westhorp, 2003).
While very few studies have focused on occu-
pational balance among older people, previous
studies have proposed a link between occu-
pational balance and retirement. Pettican and
Prior (2011) reported how retirees achieved
new routines by choosing to engage in occu-
pations that would challenge and develop indi-
vidual capabilities, and by replacing the
positive aspects of work with new occupations.
Similarly, Jonsson, Borell and Sadlo (2000)
described replacement of work with other mean-
ingful occupations, and with routines in order to
achieve occupational balance after retirement.
Although fairly extensive research into occu-
pational balance has been carried out (Wagman,
Håkansson, & Jonsson, 2015), understandings,
especially from the perspective of older people,
are lacking. With an increasingly aged popu-
lation, there is a need for older people to work
longer in order to secure the welfare state (EU-
OSHA et al., 2017). Thus, knowledge of how
an extended working life might contribute to
occupational balance is warranted. The aim of
this study was to describe occupational balance
among workers aged 65 years and beyond.
Method
A qualitative approach was used to gather data
from focus groups and individual interviews,
allowing for in depth understanding of older
workers’ experiences of occupational balance.
Participants
To maximise heterogeneity, according to sex and
work domains, recruitment sites included con-
struction and technical companies with predo-
minantly men and the community elderly care
sector with mostly women. Managers in those
work domains, from two medium-sized compa-
nies and four municipalities in the south of Swe-
den, received both written and oral information
about the research inviting their workplace to
take part in the study. Inclusion criteria were
people over the age of 65 who were still working.
The managers asked potential participants if
they would like to participate and passed on con-
tact details to the authors. Very few women and
older workers from the elderly care sector par-
ticipated in the focus groups. Therefore, man-
agers in the elderly care sector in two different
municipalities were contacted by the first author
and asked if there were any older workers who
wanted to participate in individual interviews.
Two women expressed interest. In total, 26 par-
ticipants aged 66-71 years were included in the
study (13 participants from the construction
company, 7 from the technical company, and 6
from the elderly care sector). The participants’
sociodemographic characteristics are presented
in Table 1.
Data collection
Focus groups are suitable for acquiring knowl-
edge about perceptions and beliefs regarding a

Table 1. The participants’ sociodemographic characteristics,
n = 26
Variable Categories
Sex Male
Female
Civil status Married/living with
someone/in a relationship
Single
Profession Project leader
Senior advisor
Engineer
Nurse
Assistant nurse
Working hours Full time
Part time
specific topic (Krueger & Casey, 2009; Then,
Rankin, & Ali, 2014), and generate a collective
understanding of the topic rather than an indi-
vidual perspective. Six focus groups with three
to five participants in each group were con-
ducted between March 2014 and August 2015.
Each session lasted 1.5-2 hours. To obtain
greater heterogeneity among the participants,
across gender and work domains, two individual
interviews with women from the elderly care
sector were conducted by the first author in
June and September 2016.
The focus group interviews followed guide-
lines by Krueger and Casey (2009) and were con-
ducted by three of the authors (PH, CH and KN)
who were all familiar with focus group method-
ology. The task of moderator and assistant mod-
erator alternated between them. The moderator
was primarily concerned with intense listening,
directing the discussion, deciding when more
information was needed and when to move on.
General information was given to the participants
concerning the specific topic that had been
decided on in advance, with a focus on “extended
working life”. The interviews started with an
opening question: “Why have you decided to
work beyond the age of 65?” The interview
guide covered the participants’ experiences of
occupations in everyday life, focusing on how it
used to be and how participants experienced it
currently. To more deeply capture how older
workers manage occupations in everyday life,
the opening question in the two individual inter-
views was followed by: “Can you please describe a
regular week and the occupations you engage in?”
and “How do you feel about your engagement in
the described occupations?”
JOURNAL OF OCCUPATIONAL SCIENCE 43
Using the word “balance” from the outset
might have influenced participants’ perceptions
N
of working life, hence the word was not used
19 during the recruitment process nor in the infor-
7
19 mation or consent form. Instead, “managing
everyday occupations” was used. All of the inter-
7 views were digitally recorded and transcribed
13
4 verbatim. The quotes have been translated and
3 back translated by a native English speaker.
1
5
18
Data analysis
8
Directed content analysis, as described by Hsieh
and Shannon (2005), is a suitable choice when
there is an existing theory or prior research of
a phenomenon that would benefit from further
description. Directed content analysis involves
the application of conceptual categories to a
new context and could be described as being
deductive in nature (Assarroudi, Heshmati
Nabavi, Armat, Ebadi, & Vaismoradi, 2018;
Hsieh & Shannon, 2005). Deductive content
analysis is suitable for testing categories or con-
cepts in a new context (Marshall & Rossman,
1995) when the categorization in the analysis is
based on earlier research (Hsieh & Shannon,
2005; Sandelowski, 1995). The development of
knowledge and theories derived from previous
research increases the importance of the deduc-
tive approach to refine and possibly extend a
theoretical framework (Assarroudi et al., 2018).
Any text that does not fit in the existing theory
and the predefined categories should be given
new codes and analysed to determine if it
might be a new category or a subcategory
(Hsieh & Shannon, 2005). Since it is possible
to identify previously unidentified categories,
directed content analysis is also inductive in
nature (Hsieh & Shannon, 2005).
The analysis in the present study started by
constructing a formative categorization matrix
as proposed by Assarroudi et al. (2018), with
three predetermined categories based on the
indicators of occupational balance presented in
Eklund et al. (2017): abilities and resources, har-
monious mix of occupations, and congruence
with values and personal meaning. The second
step involved profound listening to all audio-
tapes and reading all transcripts several times,
in order to make sense of the whole. Since no
insights can appear from the data without the
44 P. HOVBRANDT, G. CARLSSON, K. NILSSON, M. ALBIN & C. HÅKANSSON
Table 2. Categorization matrix: An example of steps taken in the analysis
Meaning unit
My personal strategy is that I absolutely don’t
work more than 4 days a week. I must have
Fridays off, I must be able to let work go – I
don’t take it home and work at weekends. I
have 3 days off, and in that way I manage to
recharge my batteries.
I have half an hour’s break [at work] when I go
to the gym. … in addition to the work, I take
care of my home, walking with the dogs, we
have two dogs. I have a colony and then I also
meet friends. I get time to do what I want …
… luck or bad luck, if there are things I want to
do, that I had intended to do during my life.
So, in my current situation, I would have
chosen not to work in order to do these things.
If there’s a conflict, that’s what I would have
done, actually.
researcher being completely familiar with it, this
step is crucial for extraction of related meaning
units (Elo et al., 2014; Elo & Kyngäs, 2008). In
the third step, meaning units, i.e. all text that
appeared to describe the experience of occu-
pational balance, were highlighted in the tran-
scripts. Next, the highlighted meaning units
were summarised and given codes. The codes
were then grouped and categorized according
to their meanings, similarities and differences
and linked to the predetermined categories in
the categorization matrix. See Table 2 for an
example of steps taken in the analysis.
The first author was primarily responsible for
conducting the analysis, using an iterative pro-
cess of moving back and forth between the
meaning units, categories and transcripts. The
categories, meaning units, and examples of
quotes illustrating each category were presented
to the other authors. After independently
reviewing the transcripts and chosen quotations
for accuracy, they provided feedback to the first
author. Thereafter, to strengthen trustworthi-
ness (Graneheim & Lundman, 2004; Lincoln &
Guba, 1985) consensus on the analysis was
achieved through mutual discussion between
all authors.
Ethics
Written informed consent was obtained from the
participants, and assurance that participation was
voluntary and it was possible to withdraw at any
Summarized meaning unit Codes Predefined Categories
Strategies to handle decline in Decrease in Abilities and resources
functional abilities mental ability
To be pleased with the variation Variation Harmonious mix of
and neither too many, nor too occupations
few occupations
Possibilities to change the Satisfaction with Congruence with
occupational repertoire life as a whole values and personal
meaning
time without risking negative consequences was
given by the researcher prior to each interview.
The participants were further informed that the
recorded and transcribed interviews would be
handled only by the researchers and the partici-
pants were guaranteed confidentiality in all for-
mal reporting of the findings. The study was
conducted according to the Declaration of Hel-
sinki and approved by the Regional Ethical
Review Board in Lund (2013/722).
Findings
The participants’ descriptions of how they man-
aged their daily life with work and other occu-
pations were consistent with the predefined
categories: abilities and resources, a harmonious
mix of occupations, and congruence with values
and personal meaning. The participants had a
variety of occupations and, although work was
still important and meaningful, other occu-
pations began to take place in their occupational
pattern. The findings are supported by quotes
from the interviews and labelled with Roman
numerals; I-VI represent quotes from the six
focus groups and VII-VIII come from the two
individual interviews.
Abilities and resources
Although the participants mentioned some
decrease in their functional abilities, such as
memory and hearing loss, back pain,

osteoarthritis, and asthma, they described them-
selves as healthy. However, they had to deal with
their functional decline in order to manage their
occupations and tried to prepare for a future
decline in functional ability due to ageing. Prep-
aration included increased physical training, for
example, using stairs instead of the elevator or
training at the gym. Problems due to reduced
abilities were mostly expressed in relation to
work tasks; although this did not stop the par-
ticipants from working.
You can’t move about as easily. You can’t
jump down into a pit in the same easy
way as you did 30 years ago. That’s just
the way it is, but things aren’t so bad – in
other words, the physical demands on us
aren’t that great. (II)
The participants discussed their decrease in
mental ability, such as memory loss and tired-
ness, and how they handled these declines.
Memory loss was dealt with by writing notes in
order not to forget what to do. Tiredness was
expressed as being a more serious problem and
required different kinds of strategies, including
strictly choosing what to do. Organizational fac-
tors, such as collaborations with colleagues and
managers made it, to some extent, possible to
choose work tasks that could be managed. Par-
ticipants described how they avoided involve-
ment in tasks that required too much energy
and they were careful not to do too much,
including avoiding work tasks if any stress
appeared. Another way the participants handled
tiredness was to be very strict about their work-
ing hours. In order to have time for recovery,
those participants who worked full-time had
decided to no longer work overtime, and others
had reduced their working hours.
My personal strategy is that I absolutely
don’t work more than 4 days a week. I
must have Fridays off, I must be able to
let work go – I don’t take it home and
work at weekends. I have 3 days off, and
in that way I manage to recharge my bat-
teries. I don’t work after 4:30. I leave my
computer at work and drive home. I drive
an hour to work in the morning and an
hour home, so that’s enough. … I get up
at 5:30 in the morning, and I’m back
JOURNAL OF OCCUPATIONAL SCIENCE 45
home at 5.30 in the afternoon. I’m
exhausted on Thursday evenings. (I)
However, it was not always easy to reduce work-
ing hours, as some tasks required almost full-
time work, and working part-time could result
in less interesting work tasks.
A harmonious mix of occupations
In general, the participants were very engaged in
their work. They explained that participation in
occupations outside work, such as recreation,
had been hindered previously due to high work-
loads. In order to have time for other occu-
pations, and a greater variety of occupations,
the participants described the importance of get-
ting away from work at the end of the day. By
not working overtime it was possible for them
to have a more harmonious mix of occupations.
The participants stated that they were satisfied
with their mix of occupations, which nowadays
varied in terms of being physically and mentally
demanding, challenging, relaxing, and compul-
sory. One of the participants described:
I have half an hour’s break [at work] when
I go to the gym. … in addition to the work,
then I take care of my home, walking with
the dogs, we have two dogs. I have a colony
and then I also meet friends. I get time to do
what I want. (VII)
Furthermore, some of the participants described
how they were engaged in occupations with
special importance outside of work that required
different kinds of preparation and commit-
ments, for example occupations with responsi-
bilities for certain events or competitions.
Participants also strove for regularity in occu-
pations outside work and such commitments
contributed to this structure.
I’ve arranged things so I have certain
activities [beside work] on Wednesdays,
as I need a structure – otherwise, it’s easy
for time to just run away. So, I have set
times for this and that, and now I’m
involved in different things, and as I men-
tioned I am a volunteer. I was asked
whether I wanted to become a politician,
too, but I felt somehow that was the limit.
46 P. HOVBRANDT, G. CARLSSON, K. NILSSON, M. ALBIN & C. HÅKANSSON
I didn’t dare do it, because I get so wrapped
up in things that it would eat me up and I’d
be at it for 10 hours every day. (IV)
The participants described the importance of
occupations in a social context. They prioritized
being with family and found there were
increased opportunities for family gatherings.
They travelled more, and engaged in domestic
work. Among their various occupations, partici-
pants mentioned occupations that contributed
to feelings of being needed and doing things
both for others and for themselves. For example,
the obligation to arrange events of different
kinds or competitions in a sports club contribu-
ted to feeling needed. Additionally, the partici-
pants described the importance of receiving
appreciation from their colleagues.
That’s very important. It’s very important
that people tell you how nice it is that
you’ve come and what a good job you’ve
done – no one says that at home. (V)
However, being needed was not always a positive
experience. If it was more of an obligation, for
instance taking care of a sick relative, it could
be a dilemma, and might not contribute to a har-
monious mix of occupations or occupational
balance, at least for the moment.
If we take today, my mom had surgery and
we will go to the hospital. … My wife has
been ill, so she cannot go out with the
dog. So I go with the dog, and it takes me
2 hours. My son is going on vacation and
I have to help him because he has a pro-
blem with his car. And I can’t do all three
things in the hours after work – it’s imposs-
ible. I can’t do it - I have to let go. And I do
not visit my mom. I’ll do it tomorrow,
which I think is a shame, but I have to let
go of something. (VI)
Congruence with values and personal
meaning
The participants were conscious of their
approaching retirement and tried to find strat-
egies to prepare for life as a retired person.
They had, to some extent, changed their occu-
pational patterns and increased their time for
valuable occupations outside work. Based on
their long experiences of work, they now had
thoughts about their life as a whole and reflected
on what life would be like in the future. Besides
the working role, they discussed meaningful
roles including being a friend, a parent, and a
grandparent. Having these valuable roles
appeared to be crucial since ending their work-
ing life generated feelings of grief and sorrow:
“It is a sorrow to be separated from my work. A
bit like a divorce” (I). Even if retirement was
seen as a time of grief, it could also be an oppor-
tunity to fulfil other dreams such as becoming a
student: “that is something I have always wanted
to do” (VI).
Alternatively, if there were no other occu-
pations that were as meaningful as work, and
the participants were not allowed to work
beyond the age of 67, changing profession
could be an option.
I find it boring being at home. I sometimes
get lonely. But then again, I’m not a par-
ticularly domestic person. I clean what
has to be cleaned and I don’t bake. I’m
not that kind of person, and I don’t enjoy
it. … But I can’t stay at my job – you
can’t stay past 67. But I’ll work [somewhere
else]. (VIII)
The participants described prioritising among
occupations in their daily life and choosing to
be engaged in occupations that were particularly
meaningful for them. Among the mentioned
occupations, some were more valued than
others, such as singing in a choir for example,
as expressed by one of the participants.
Then we have one thing in common, the
song, and we concentrate on it completely.
We forget everything else, work and so on,
just for that moment, even our families. (II)
If there were conflicts between valued occu-
pations, they stated that satisfaction with life as
a whole was most important. Thus, work
would not be a priority since life was too short.
Participants did not deem this a difficult choice.
You only live once, so for an 80-year-old
Swedish man it’s a bit of a case of math-
ematics, luck or bad luck, if there are things
I want to do, that I had intended to do

during my life. So, in my current situation,
I would have chosen not to work in order to
do these things. If there’s a conflict, that’s
what I would have done, actually. (III)
Discussion
This qualitative study explored occupational bal-
ance from the perspective of older workers
beyond the age of 65. The most prominent
finding was that work contributed to occu-
pational balance. Too much work earlier in
life, which did not give the participants opportu-
nities for having other meaningful occupations,
meant participants now prioritised differently,
seeking more balance between their daily occu-
pations. Even if work was considered to be
very important, the participants expressed how
having a variety of occupations offered chal-
lenge, social aspects, satisfaction and meaning.
The findings are discussed in relation to the
three indicators of occupational balance: abilities
and resources; a harmonious mix of occu-
pations; and congruence with values and per-
sonal meaning (Eklund et al., 2017).
Abilities and resources
The participants in the present study must be
considered healthy. Even if the ageing process,
with some functional decline, was evident, this
was not mentioned as a big problem. The pres-
ence of functional decline did not prevent par-
ticipants from managing work tasks; further,
they had decided to prepare for increasing func-
tional decline. This aligns with previous findings
that people with self-reported good health are
best placed to work into older age (Hofäcker &
Naumann, 2015) and that the benefits derived
from working, including identity and self-fulfill-
ment, support health (Hovbrandt, Håkansson,
Albin, Carlsson, & Nilsson, 2017; Jahoda,
1981). It also underlines the importance of sup-
porting older people’s health if they are to con-
tinue to work. This will particularly be the case
for more vulnerable groups with lower edu-
cation, existing health conditions, and poor
occupational balance.
The present study also supports previous
findings that organizational factors such as
opportunities for independence, skills
JOURNAL OF OCCUPATIONAL SCIENCE 47
development, and reduced work time contrib-
utes to both willingness to extend working life
(Anxo et al., 2017; Hovbrandt et al., 2017; Nils-
son, 2018) and occupational balance (Syrek,
Apostel, & Antoni, 2013). Thus, good working
conditions must be considered an important
organizational factor for occupational balance
and a sustainable working life that could con-
tribute to possibilities for an extended working
life and active ageing. Consistent with the con-
cept of “healthy ageing”, the need for actions
to enable older people to remain a resource to
their families, communities and economies, is
emphasized (World Health Organization,
2017). Consequently, it is important to optimize
opportunities for valued occupations, such as
work, and a variety of occupations that contrib-
ute to health for older people and allows them to
use and develop their capacity for work (Yerxa,
1998).
A harmonious mix of occupations
In addition to the positive challenge work
afforded, participants were engaged in other
occupations. They described the variety of
work and other occupations, both in and outside
of the home, as taking time and commitment.
The participants did not want occupations that
consumed all their energy, as work had pre-
viously done; therefore, they chose to work
fewer hours than before. However, the partici-
pants also added new occupations to their occu-
pational pattern in order to achieve occupational
balance. When occupational balance was
assessed in a time-use intervention it was
found that increased time spent in more occu-
pations contributed to occupational balance
(Edgelow & Krupa, 2011). The findings in the
study by Edgelow and Krupa (2011) showed
how the treatment group, that spent both more
time in different occupations and had more vari-
ation in their occupational pattern, achieved an
increased occupational balance. Above all, it
seems — as in the case among the participants
in the present study, who were working to a
varying extent — that an extended working life
contributed to occupational balance since they
made more conscious choices between different
occupations. However, their choice of occu-
pational engagement may not have been related
48 P. HOVBRANDT, G. CARLSSON, K. NILSSON, M. ALBIN & C. HÅKANSSON
to time or to the number of occupations they
were engaged in, but rather to how they valued
different occupations.
Congruence with values and personal
meaning
Being close to retirement, the participants were
aware they were going to lose one of their
most valuable occupations, namely work. That
the participants chose meaningful occupations,
in order to get a harmonious mix of occupations,
may justify the assumption that occupational
balance is closely related to experience of values
and personal meaning (Håkansson et al., 2006).
Considering that participants based their choices
of occupations on how they valued occupations,
it could be that value and meaning is the most
important indicator of occupational balance.
Further studies are needed to explore how
important the meaning aspect in occupations is
for experiencing occupational balance.
In the present study, participants reflected on
their whole life, and it was important for them to
do things to fulfill their dreams and to shape
the rest of their lives on an individual basis. It
was obvious how — besides work — they valued
their family life, and prioritized doing occu-
pations with and for their families. However,
caregiving for grandchildren by grandmothers
contributed to occupational balance and satis-
faction only if time for caregiving did not take
away from other meaningful occupations (Lud-
wig, Hattjar, Russell, & Winston, 2007). The
meaning individuals give to different social con-
texts such as being a part of families, a colleague
in the work environment, or a member of an
organization i.e. socio-symbolic value, has been
found to be important in previous research
(Erlandsson, Eklund, & Persson, 2011). Based
on the findings in the present study it seems as
though social contexts are important for occu-
pational balance among older workers.
Feelings of grief upon retiring were obvious
among some of the participants. Being forced
to leave work due to reaching the retirement
age of 67, in this study within the elderly care
sector, may cause feelings of not being useful
anymore, especially if there are few other mean-
ingful occupations. Considering the demo-
graphic changes in Europe and the Western
world, with older people making up a greater
proportion of the population, there will be a
need for people to work longer. However, pol-
icies such as raising the statutory retirement
age are likely to be difficult, especially for people
who are not able to work until retirement age
due to ill health and work environmental factors
(Hofäcker, Hess, & Naumann, 2015).
Ageism in the workplace as well as in society
at large favors the privilege and right to work for
younger workers over that of older workers
(Laliberte Rudman, 2015). Consequently,
together with raising the statutory retirement
age, actions for health promotion, combating
ageism, and preventing work injuries are crucial
to ensure sustainable work for all. Opportunities
to stay in working life through bridge employ-
ment (Alcover, 2017) and career reinvention
(Arbesman, 2015) might be solutions for conti-
nuing individual development for older people.
Bridge employment and career reinvention sup-
port financial security and strengthen inter-
actions with others, and may also be a way to
achieve occupational balance for older people.
Thus, policy makers could provide opportunities
for continued participation and recognize older
people as a resource in the labor market (Wol-
verson & Hunt, 2015).
For older people, it is necessary to have occu-
pations that provide as much meaning and pur-
pose as work once did, with possibilities for
continued development (Wilcock & Hocking,
2015). In the present study, the participants
chose an extended working life that contributed
to development through interesting and challen-
ging work tasks, while at the same time increasing
other valuable occupations outside work. Individ-
uals choose to stay in work or to retire due to four
considerations: their health in relation to recovery
time, and the physical and mental demands of the
work environment; their personal economic situ-
ation; opportunities for social participation in and
outside of work; and the possibility of using their
skills and having self-crediting1 meaningful occu-
pations (Nilsson, 2016; Nilsson, Hydbom, &
Rylander, 2011). Based on their abilities and
resources, the participants in this study strove
for a more harmonious, meaningful mix of occu-
pations, thus achieving occupational balance.
Furthermore, the participants changed their
occupational pattern according to their values

and meaning of occupations and they had oppor-
tunities to prioritize and chose valuable occu-
pations that contributed to occupational balance.
However, people do not always have such
opportunities and occupational potential,
defined as the “capacity to do what is required
and what they have the opportunity to do, to
become whom they have the potential to be”
(Wicks, 2005, p. 137). Occupational potential
develops during the life course and is affected
by environmental as well as personal influences
(Wicks, 2005). The participants in the present
study described how barriers such as high work-
loads hindered a harmonious mix of valuable
occupations. Such barriers may have negative
consequences for occupational balance and
occupational potential in late adulthood. People
who participate in meaningful occupations
throughout the life-course are more likely to
develop their occupational potential when they
are very old (Wicks, 2005). Thus, older people
should be recognized as having potential to be
productive and valuable for society, and possibi-
lities for an extended working life could contrib-
ute in that respect. Furthermore, from an
occupational justice perspective, all people
should have access to chosen or necessary occu-
pations regardless of age, disability, gender or
culture (Stadnyk, Townsend, & Wilcock, 2014).
Older people are a heterogeneous group with
different individual capacities, prerequisites and
desires. Combating ageism and avoiding a
stereotypical picture of the group is vital (Eriks-
son, Lilja, Jonsson, Petersson, & Tatzer, 2015;
Harris et al., 2017). Instead, older people should
be considered a resource with capabilities that
contribute to both their personal development
and health. Such an approach supports occu-
pational potential as well as a sustainable society
(Cronin-Davis & Wolverson, 2014).
Methodological Considerations and
Further Research
Findings in the present study were derived from
direct content analysis, which allows for a struc-
tured deductive approach to qualitative data.
The main strength of a direct content analysis
is that an existing theory can be supported and
extended by new identified categories and
thereby also be inductive (Assarroudi et al.,
JOURNAL OF OCCUPATIONAL SCIENCE 49
2018; Hsieh & Shannon, 2005). One limitation
of using direct content analysis might be the
established framework, since researchers
approach the data with bias. There might be a
risk that the findings are more supportive rather
than non-supportive of the predefined cat-
egories. In the present study, the predefined cat-
egories were not used to guide data collection;
rather, they were only applied during the
analytical process. Nor were probe questions,
during the interviews, related to the predefined
categories that might act as cues to answers
from the participants (Hsieh & Shannon, 2005).
In terms of trustworthiness, the quality of a
content analysis depends on the availability of
rich and appropriate data. Even with the small
groups in this study, the discussions were lively
and this has been shown to be more important
than the number of participants in focus group
discussions (Dahlin-Ivanoff, 2002). The data col-
lection extended over a year (Graneheim & Lund-
man, 2004); however, there were no changes in
any regulations during data collection, for
example in relation to retirement age that might
have affected the participants’ perceptions. The
findings represent older workers, from two differ-
ent work domains, and their perceptions of occu-
pational balance. As more than half the sample
consisted of project leaders, which is a highly
selective group, in regard to both education and
high wages, the findings may not be transferable
to other cultural contexts.
Further research is required to understand
better how to promote occupational balance
and a sustainable working life. The fact that
well-educated workers with highly-skilled and
less physically demanding work tasks are more
likely to extend their working life increases the
risk for a healthy worker bias. Thus, further
studies are needed in working areas with greater
differences in the sample. In particular, as the
occupational pattern consistently changes over
the lifespan, research utilising a life course per-
spective to capture possible relationships
between occupational balance and occupational
potential would be valuable.
Conclusion
This study contributes to the occupational
science literature by providing insights into
50 P. HOVBRANDT, G. CARLSSON, K. NILSSON, M. ALBIN & C. HÅKANSSON
occupational balance among healthy older
workers. The participants described how occu-
pational balance had been hindered due to
high workload earlier in life; whereas good
working conditions with support from managers
now gave them the ability to influence work
tasks as well as work time. Occupational balance
was dependent on a harmonious mix of mean-
ingful occupations. The findings showed the
importance of occupational balance for active
and healthy ageing and as a prerequisite for an
extended working life. The concept of occu-
pational balance has received great attention in
occupational science but mostly from the per-
spective of people younger than 65 years of
age. This study adds to the knowledge of occu-
pational balance among older workers beyond
age 65.
End Note
1. The term ‘self-crediting occupations’ has the same
meaning as occupations with self-reward value, as
explained by Persson, Erlandsson, Eklund, and Iwars-
son (2001). That is, an occupation where enjoyment is
the main characteristic.
Acknowledgments
The authors thank Kristine Lund and Mark Porter for
valuable translation support. This study was funded by
the Swedish Research Council for Health, Working Life
and Welfare.
ORCID
Pia Hovbrandt
http://orcid.org/0000-0002-6311-1934
Gunilla Carlsson
http://orcid.org/0000-0002-5955-3625
Kerstin Nilsson
http://orcid.org/0000-0002-3193-205X
Maria Albin
http://orcid.org/0000-0002-6613-4437
Carita Håkansson
http://orcid.org/0000-0002-3660-3079
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