Home and Community Care Digest
Methods: Qualitative investigations of two assisted living residences in New England revealed numerous issues for further exploration. On the basis of these investigations, a theoretical model of place integration was developed, as well as a questionnaire for a second phase of research. In this second phase, a sample of 35 residences in four states was drawn, representing between 400 and 500 residents in each state. The questionnaire was delivered by residence administrators and was completed by 297 assisted living residents. The results were used to analyze the sense of feeling at home. The outcome variable used in the study- whether the resident had become at home in his or her residence- was based on the question "Do you consider your assisted living residence home?"
Findings: The authors reported a relationship between the social and physical attributes of assisted living and resident satisfaction/quality of life. The study stresses that place attachment to town and community is a necessary, but insufficient condition, to facilitate older adults' processes of feeling at home. The greater the attachment to town or community, the less likely the individual is to become 'at home' in assisted living. A move to an assisted living residence in a town or community where one has important place attachments assists the transition and processes of becoming at home when social involvement and valuation of place are also at work. Attachment to one's town or community was found to be insignificant when considering an individual's ability to successfully age in place in an assisted living residence. The longer the length of stay in the community, the less likely the individual would feel at home in the residence. These individuals were also more likely to consider their assisted living residence as temporary accommodation, similar to a hotel.
Conclusions: The idea of aging in place promotes the notion of remaining in one's community even if a caregiving environment such as assisted living is necessary. Nonetheless, the study does not necessarily support this view. As individuals move from the community to assisted living, they need to reintegrate themselves with the new residence and setting. The theory of place integration suggests that the process of integration is ongoing and that aging in place should be viewed as an active, ongoing process to create new meanings as circumstances change.
Reference: Cutchin, Malcolm P, Owen, Steven V, and Chang, Pei-Fen J."Becoming "at Home" in Assisted Living Residences: Exploring Place Integration Processes". Journal of Gerontology: Social Sciences, 2003; 58B (4), S234-S243
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