THE VALUE OF INDEPENDENCE IN ASSISTED LIVING FACILITIES

辅助生活设施的独立性的价值

• 批准号: 2718617
• 负责人: PAULA C CARDER
• 金额: $ 3.24万
• 依托单位: PORTLAND STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-01 至 1999-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2718617
• 关键词: behavioral /social science research tag; clinical research; frail elderly; functional ability; health related legal; health services research tag; human subject; patient care personnel relations; quality of life; residential care facility

Independence is a central theme in gerontological research, policy, and practice. Surveys and psycho-social studies indicate that seniors want to maintain independent lives and that the ability to do for oneself and make decisions is positively correlated with well-being and health. As people reach very old age, that is, over age 80, they are more likely to suffer from chronic health conditions or cognitive impairments that affect their ability to live alone. A variety of long-term care options that address the health and social needs of such individuals are increasingly available, yet, there is still limited and fragmented support for programs that serve disabled older persons who do not require skilled nursing care. Many people who have relatively minor health problems or physical disabilities have no option but to go to a nursing facility where loss of independence may be part of the organizational reality. In Oregon, assisted living facilities, which serve both private-pay and Medicaid clients, offer an alternative to institutionalization for frail elders who have a variety of complex health or social needs, but who do not require skilled nursing care. Residents might have diabetes, Parkinson's disease, Alzheimer's disease, or stroke. Because assisted living facilities are staffed 24-hours a day, they are able to respond to unscheduled needs, such as falls, incontinence, or pain. A major feature of Oregon's assisted living model is a respect for resident independence, privacy and dignity. This model has attracted national, and international attention, yet little is known about the "philosophical" side of assisted living. In particular, how do assisted living facilities balance respect for an individual's personal choices with the need to protect? The proposed research builds on an expanding body of research on assisted living by focusing on this intriguing element which, it may be argued, is the basis of the appeal of assisted living residences. The specific aims are: 1. To explore how the state agency responsible for licensing and monitoring assisted living implements the philosophical component of assisted living, especially resident independence. 2. To explore how assisted living facilities respond to residents' desire for independence on a daily basis. These aims will be attained through a multi-site case study. The principle investigator will attend state-required training for assisted living directors and observe training of direct care staff in two assisted living facilities. In addition, the PI will observe the daily operations of these facilities. Residents and their family members will be interviewed regarding their decision to move, their personal preferences, and how assisted living compares to their prior living arrangements.

独立性是老年学研究、政策和 实践 调查和心理社会研究表明，老年人希望 维持独立生活的能力， 做决定与幸福和健康正相关。 作为 人们到了很老的年龄，也就是80岁以上， 患有慢性健康状况或认知障碍， 影响他们独自生活的能力。 多种长期护理选择 满足这些人的健康和社会需求的措施包括： 越来越多，然而，仍然有有限的和分散的 支持为没有能力的残疾老年人服务的方案 需要熟练的护理。 许多人有相对较小的 有健康问题或身体残疾的人别无选择，只能去一个 护理设施，其中丧失独立性可能是 组织现实。 在俄勒冈州，辅助生活设施， 为私人支付和医疗补助客户提供服务， 为体弱长者提供院舍服务， 健康或社会需要，但不需要熟练的护理。 居民可能患有糖尿病，帕金森氏症，阿尔茨海默氏症， 或者中风因为辅助生活设施24小时都有工作人员， 一天，他们能够对计划外的需求做出反应，比如福尔斯， 失禁或疼痛。 俄勒冈州辅助生活的一个主要特点是 这种模式是对居民独立、隐私和尊严的尊重。 这 这种模式引起了国内和国际的关注，但很少 被称为“哲学”的一面辅助生活。 在 特别是，辅助生活设施如何平衡尊重 个人的选择与保护的需要？ 拟议 研究建立在不断扩大的关于辅助生活的研究基础上， 集中在这个有趣的元素，它可能会被认为是， 协助居住的上诉依据。 具体目标 是：1.探讨负责许可证发放和 监测辅助生活实施的哲学组成部分， 协助生活，特别是居民独立。 2.探讨如何 辅助生活设施回应居民独立的愿望 按日 这些目标将通过多地点个案研究来实现。 的 主要研究者将参加州要求的培训， 生活主任和观察培训的直接护理人员在两个 辅助生活设施。 此外，PI将每天观察 这些设施的运营。 居民及其家属将 就他们的搬家决定接受采访，他们的个人 偏好，以及如何辅助生活与他们以前的生活相比， 安排