In the late 1980's assisted living emerged as a self-proclaimed new style of providing long-term care and supportive services. Assisted living as espoused by its early proponents and by industry leaders embodied certain specific philosophical tenets, such as dignity, autonomy, meeting scheduled and unscheduled needs and aging in place, in their daily operations. These tenets distinguished assisted living from other forms of institutional care such as nursing home care. In the past twenty years the assisted living industry has matured and grown substantially. However, despite the maturing of the industry and the general agreement on the basic tenets little is known about the degree to which the industry embodies these principles.
In addition public policy and consumer preferences have grown in their focus on substituting assisted living for nursing home care. Moreover, the degree to which assisted living can and does substitute for nursing home care has been largely unexamined. Elder care advocates and researchers have more and more called attention to the increasing acuity level of assisted living residents.
This study consists of three related components, each of which will broaden the understanding of current assisted living facilities and their residents. The first study examines person environment fit in assisted living. Lawton's theory of person environment fit, has largely defined the construction and physical environment of assisted living since the 1980's. Changes in Lawton's theory were proposed by Guiata and Jones in the Journal of the American Medical Association in 2012 in reaction to the increased level of dementia in assisted living residents. A third non-theoretical analysis using exploratory factor is designed assist with development of new constructs in person environment fit theory. The second study examines changes in assisted living facilities and residents from 1999 to 2010. This study uses the only two national surveys of assisted living, The 1999 National Survey of Assisted Living and the 2010 National Survey of Residential Care Facilities. This study will examine both facility level and resident level characteristics to explicate resident acuities and to examine the degree to which facilities are accommodating these acuities. The third study examines facility characteristics associated with discharge of residents from assisted living facilities. Understanding resident discharge from assisted living will give a better understanding how assisted living facilities meet scheduled and unscheduled needs of residents as well as embody the philosophical concept of aging in place.
The contribution of this research is improved understanding of the current assisted living facilities and residents and better understand the importance of facility characteristics in person environment fit and in aging in place. This contribution is significant because assisted living residents are a vulnerable population with no protection under federal statutes and limited protection in most states. If indeed, as advocates and researchers assert, assisted living residents mirror nursing home residents in acuity then this research will assist with developing policies to protect this vulnerable population.
|Advisor:||Hawes, Mary Catherine|
|Commitee:||Huber, John C., Kash, Bita, Phillips, Charles D.|
|School:||The Texas A&M University System Health Science Center|
|Department:||Health Policy & Management|
|School Location:||United States -- Texas|
|Source:||DAI-A 74/11(E), Dissertation Abstracts International|
|Subjects:||Social research, Gerontology, Aging|
|Keywords:||Aging, Assisted living, Geriatrics, Gerontology, Institutional care, National Survey of Residential Care Facilities, Person-environment fit|
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