Becoming "at home" in assisted living residences: exploring place integration processes.

OBJECTIVES This study explores the roles of place attachment, nonfamily social involvement, place valuation, and individual characteristics in the process of becoming at home in assisted living residences. METHODS Purposive sampling and cross-sectional data by means of a questionnaire completed by current assisted living residents in four states (N = 297) were used to estimate a structural equation model to explain becoming at home. RESULTS Place attachment to town and community is a necessary but not sufficient explainer of older adults' process of becoming at home. Nonfamily social involvement plays a pivotal role through which place attachment works to explain becoming at home. Both place valuation and nonfamily social involvement exhibit direct positive effects on the outcome. DISCUSSION Findings support a transactional interpretation of assisted living as home. The relationship between place attachment to one's community and full integration into assisted living is more complex than currently acknowledged.

[1]  J. H. Steiger.  Statistically based tests for the number of common factors , 1980 .

[2]  P. Kontos.  Resisting institutionalization: Constructing old age and negotiating home , 1998 .

[3]  Y. Tuan,et al.  Place: An Experiential Perspective , 1975 .

[4]  M. Rose,et al.  The effect of long-term care environments on health outcomes. , 2000, The Gerontologist.

[5]  Jeanne Moore,et al.  PLACING HOME IN CONTEXT , 2000 .

[6]  L. Cuba,et al.  A Place to Call Home: Identification With Dwelling, Community, and Region , 1993 .

[7]  Judith C Hays,et al.  Living arrangements and health status in later life: a review of recent literature. , 2002, Public health nursing.

[8]  Robert S. Weiss,et al.  Challenges of the third age : meaning and purpose in later life , 2002 .

[9]  R. Chapin,et al.  Aging in place in assisted living: philosophy versus policy. , 2001, The Gerontologist.

[10]  I. Altman,et al.  Place attachment: A conceptual inquiry. , 1992 .

[11]  J. Dewey.  Experience and Nature , 1960 .

[12]  M. Cutchin.  Deweyan Integration: Moving beyond Place Attachment in Elderly Migration Theory , 2001, International journal of aging & human development.

[13]  P. Bentler,et al.  Comparative fit indexes in structural models. , 1990, Psychological bulletin.

[14]  J. S. Long,et al.  Testing Structural Equation Models , 1993 .

[15]  Malcolm P Cutchin,et al.  The process of mediated aging-in-place: a theoretically and empirically based model. , 2003, Social science & medicine.

[16]  Stephanie J. Fonda,et al.  Patterns in functioning among residents of an affordable assisted living housing facility. , 2002, The Gerontologist.

[17]  Patricia A. Parmelee,et al.  Attachment to Place and the Representation of the Life Course by the Elderly , 1992 .

[18]  H. Proshansky,et al.  Place-identity: Physical world socialization of the self , 1983 .

[19]  R. Kane.  Long-term care and a good quality of life: bringing them closer together. , 2001, The Gerontologist.

[20]  R M Hammer,et al.  The lived experience of being at home. A phenomenological investigation. , 1999, Journal of gerontological nursing.

[21]  B. Kemp,et al.  Quality of life in assisted living homes: a multidimensional analysis. , 2000, The journals of gerontology. Series B, Psychological sciences and social sciences.

[22]  B. L. Combs,et al.  Quality of Life in Assisted Living Facilities: Viewpoints of Residents , 2000 .

[23]  R. MacCallum,et al.  Power analysis and determination of sample size for covariance structure modeling. , 1996 .

[24]  Understanding John Dewey: Nature and Cooperative Intelligence , 1995 .

[25]  Ethel Shanas,et al.  Handbook of Aging and the Social Sciences , 1991 .

[26]  P. Bentler,et al.  Cutoff criteria for fit indexes in covariance structure analysis : Conventional criteria versus new alternatives , 1999 .

[27]  J. S. Long,et al.  Testing Structural Equation Models , 1993 .

[28]  Heather M. Young,et al.  Moving to congregate housing: The last chosen home , 1998 .

[29]  E. Sikorska.  Organizational determinants of resident satisfaction with assisted living. , 1999, The Gerontologist.

[30]  F. Carp.  Short-term and long-term prediction of adjustment to a new environment. , 1974, Journal of gerontology.

[31]  R L Kane,et al.  Outcome trajectories for assisted living and nursing facility residents in Oregon. , 2001, Health services research.

[32]  B. Marini.  Institutionalized older adults' perceptions of nurse caring behaviors. A pilot study. , 1999, Journal of gerontological nursing.

[33]  David Seamon.  A Geography of the Lifeworld : Movement, Rest and Encounter , 1979 .

[34]  I. Altman,et al.  Handbook of environmental psychology , 1987 .

[35]  P. Bentler.  Comparative Fit Indices in Structural Models , 1990 .