Expanding Capabilities in Integrated Service Areas (ISAs) As Communities of Care: A Study of Dutch Older Adults’ Narratives on the Life They Have Reason to Value

We apply the capability approach to understand the scope and limitations of community efforts to support older adults dwelling in integrated service areas (ISAs) in the Netherlands. An ISA is a neighborhood-based form of care organization aimed at the widening of opportunities to achieve well-being goals by building on local community resources. To gain insight in the complex effects of ISAs on older adults’ well-being, a narrative study was performed on their daily lived experiences. Emerging narrative patterns were aggregated in a Manifesto of the Independently Living Older Person. Narrative patterns and Manifesto provided insight in both respondents’ capabilities and functionings, expressing values such as autonomy, human dignity and contributions to community care by older adults themselves. Older adults balance realistic and optimistic expectations for the future in ways that can be explained using the concepts of capability security, adaptive preferences, care-receiving and caring-with. Since interventions transpire through local interactions and shared practices, ISAs represent a social space in between individuality and collectivity where older adults enact community by sharing common ends. Findings imply that the complex interventions developed in ISAs expand older adults’ capabilities involving the challenge for all stakeholders to negotiate individual freedoms in community care settings.