THE VALUE OF INDEPENDENCE IN ASSISTED LIVING FACILITIES

独立性是老年学研究、政策和研究的中心主题 练习一下。调查和心理社会研究表明，老年人希望 保持独立的生活，为自己做事情的能力和 做决定与幸福和健康呈正相关。AS 人们到了很老的年龄，也就是80岁以上，他们更有可能 患有慢性健康状况或认知障碍 影响他们独自生活的能力。各种长期护理选择 解决这类个人的健康和社会需求的是 越来越多的可用资源，然而，仍然有有限和分散的 支持为残疾老年人提供服务的方案 需要熟练的护理。许多人有相对次要的 健康问题或身体残疾别无选择，只能去找 护理机构，在那里失去独立性可能是 组织现实。在俄勒冈州，辅助生活设施， 同时服务于私人支付和医疗补助客户，提供替代方案 为有各种情结的虚弱老年人提供机构 健康或社会需求，但不需要熟练护理的人。 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。因为辅助生活设施一年24小时都有工作人员 白天，他们能够对计划外的需求做出反应，比如摔倒， 大小便失禁，或疼痛。俄勒冈州辅助生活的一大特点 典范是对居民独立性、隐私和尊严的尊重。这 模特吸引了全国和国际的关注，但却很少 人们都知道辅助生活的“哲学”方面。在……里面 特别是，辅助生活设施如何平衡对 个人的个人选择需要保护吗？建议数 研究建立在不断扩大的关于辅助生活的研究主体之上 关注这一耐人寻味的元素，可以说，这是 这是辅助生活住房上诉的基础。具体目标 是：1.探索国家机构如何负责许可和 监测辅助生活实现了以下哲学组成部分 辅助生活，尤指居民独立生活。2.探索如何 辅助生活设施回应居民独立的愿望 每天都有。 这些目标将通过多地点案例研究来实现。这个 首席调查员将参加国家要求的受助人员培训 活着的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，私家侦察将遵守每日 这些设施的运作。居民和他们的家人将 就搬家的决定接受采访，他们的个人 偏好，以及辅助生活与他们以前的生活相比如何 安排好了。

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.