Facility Ownership and Resident Satisfaction with Assisted Living

Abstract

Although the majority of assisted living facilities operate as for-profit organizations and serve increasingly frail elderly populations, little is known about the impact of ownership on the quality of care in assisted living. This study examines the relationship between facility ownership and the quality of care in assisted living, using resident satisfaction as a quality indicator. The assessed aspects of satisfaction include health care, housekeeping, physical environment, relationships with staff, and social life/activities. The relationship of facility ownership to resident satisfaction is examined controlling for resident psychological well-being, functional ability, facility size, and staff resources. Data were collected in personal interviews with 156 residents, including 96 residents in eight for-profit facilities and 60 residents in five nonprofit facilities in Maryland. Residents in the sampled nonprofit facilities were more satisfied with assisted living than were residents in the for-profit facilities. In particular, residents in nonprofit facilities were more satisfied with health care, physical environment, and social life/activities in the facility. Better understanding of the relationship between facility ownership and resident satisfaction can help administrators create environments that maximize resident satisfaction in both nonprofit and for-profit facilities.     

TigerPlace,A State-Academic-Private Project to Revolutionize Traditional Long-Term Care

ABSTRACT

The Aging in Place Project at the University of Missouri (MU) required legislation in 1999 and 2001 to be fully realized. An innovative home health agency was initiated by the Sinclair School of Nursing specifically to help older adults age in place in the environment of their choice. In 2004, an innovative independent living environment was built and is operated by a private long term care company, as a special facility where residents can truly age in place and never fear being moved to a traditional nursing home unless they choose to do so. With care provided by the home care agency with registered nurse care coordination services, residents receive preventative and early illness recognition assistance that have markedly improved their lives. Evaluation of aging in place reveal registered nurse care coordination improves outcomes of cognition, depression, activities of daily living, incontinence, pain, and shortness of breath as well as delaying or preventing nursing home placement. Links with MU students, faculty, and nearly every school or college on campus enrich the lives of the students and residents of the housing environment. Research projects are encouraged and residents who choose to participate are enjoying helping with developing cutting technology to help other seniors age in place.     

Some aspects of a Housing Officer's work

Abstract

This paper reviews the benefits claimed to flow from the commencement of the Aged Care Act 1997. It is concluded that in restructuring residential aged care services the Commonwealth Government has withdrawn from its regulatory responsibility of ensuring residents receive adequate standards of care. To legitimate its actions the Government contractualised the relationship between service providers and residents, to the detriment of the residents.     

The subject of objects: Marx,new materialism, & queer forms of life

Abstract

This article examines two interrelated themes in the scholarship categorized as ‘new materialism’: first, the aim to undermine the subject/object distinction; second, the proposition that agency exists across the material world. While new materialists, such as Jane Bennett, conceive of their approach as an intervention against the injurious effects of capitalism, I argue that destabilizing the object/subject binary and endowing inanimate objects with vitality and agency is actually a constitutive feature of capitalism itself. To illustrate this point, I turn to Marx’s analysis, providing a queer reading of his theorization of commodities. Revisting Marx’s account of commodity fetishism in tandem with new materialism yields fresh insights into the logics of capitalism, specifically, the manner in which it thrives on concurrently producing and erasing subjectivities, thereby distorting social materiality and material sociality.     

Quality of Life in Nursing Homes

Abstract

The Nursing Home Reform Act (NHRA) of 1987 established nursing home requirements and dually emphasized quality of care and quality of life outcomes. We researched elders' perceptions of quality of life in nursing homes using focus groups. Analysis revealed four major themes important to residents: generativity, spiritual well-being, homelike environment, and privacy. Themes were used to analyze the disparity between NHRA's goal of dual emphasis and the dominance of quality of care in the treatment of frail elders living in nursing homes. Policies and procedures must be developed that promote decisional control in everyday matters of an older person's life.     

Developmental,Familial, and Peer Deterrents to Adoption Placement

ABSTRACT

This article focuses on the developmental, familial and peer deterrents that form barriers to adoption placement among teen mothers in a residential facility. An Eriksonian developmental model is used to explore developmental issues of identity, projective identification, and industry among teens. The findings suggest that family “cutoffs” and “re-admissions” also serve as deterrents to adoption placement. Additionally, peer pressure from residents of the facility form barriers to adoption placement. Teen mothers express how they were deterred from adoption placement and constrained into child-rearing as pregnancy resolution strategies. This qualitative study gives family therapy interventions as suggestions to facilitate adoption placement through addressing the constraints teen mothers face.     

Chapter 3 Residential Care Facilities for the Elderly

Abstract

Residential Care Facilities for the Elderly (RCFEs), known as board and care homes, are licensed in California and many other states for non-medical care in the community. RCFEs are examined here to provide illustrative issues in the definition of types of long-term residential care. The research examines physical functioning, social supports, and course of residential placement for 109 RCFE residents (mean age 84 years). A significant portion of the residents had personal assistance needs not usually provided at the RCFE level (75% assistance with medication, 52% used walking aids, 29% assistance in bathing). Additionally, a third of the residents had restricted social supports and social activity. Residents report declines in functioning and support as reasons for moving to residential care. Length of residence in the facility (range less than a year to 15 years) was not related to physical functioning or social activity. These findings do not support “aging in place,” within the facility, as the rationale for increased need for assistance in residential care. Implications include the need to maintain the social model of residential care ample for the majority of residents while assuring the availability of a higher need for assistance of a significant portion of the residential care population.     

A Global-Middle-Class House?1 Cultural Capital,Taste, and Kitsch

Abstract

In this article, I show how the category of the migrant house, as has been recently discussed in much scholarship, can be expanded to include another subcategory—the global-middle-class house. Recently, the migrant house has generated much research in migration studies and in disciplines of the built environment. Consequently, it has been examined through various perspectives, including home and belonging, materiality in the home, and the transnational home. It has not been examined, however, through the concepts of cultural capital, taste and kitsch, as developed by Bourdieu and others. This article applies these concepts in the exploration of the migrant house through a case study of one house and its transformation from old to new in suburban Melbourne. The article shows how the concepts of cultural capital, taste and kitsch can be utilized to expand the category of the migrant house to include the global-middle-class house. Following a theoretical discussion, the article analyses the old family house, the decision to demolish, the construction process and the redevelopment of a new house, together with an analysis of material objects in the new house and around it. The article argues that this is a specific kind of a migrant house, a global-middle-class house, because it combines popular global taste with objects taken from the ancestral past of its migrant residents.     

Letters

Abstract

Approximately 500,000 children were institutionalised in Australian orphanages and other forms of children's Homes over the course of the 20th century. However, growing up in care is not just a part of childhood; it can have ongoing impact across a person's life. Access to records can be a very important way in which people who grew up in institutional care construct the story of their lives, contributing to their self-identity, and also find out practical information, such as their exact date of birth and medical history. The present article takes as its starting point a recommendation of the third of the Australian Government reports concerned with the institutionalisation of Australian children—Forgotten Australians—and draws on interviews with former residents of children's Homes aged between 42 and 76 years to examine their access to records in Australia. We discuss a case study, the unique Heritage Information Service at MacKillop Family Services, which supports former residents to access their records, and consider the implications for good practice of agencies working in this area.     

Planning for Aging in Place: Incorporating the Voice of Elders to Promote Quality of Life

Abstract

Aging in place offers emotional and physical benefits; however, challenges associated with advanced age may make aging in place difficult. As communities across the country prepare for forecasted increases in the proportion of older residents, it is important to understand barriers that may prevent aging in place. Perceived barriers voiced by residents of a suburban county who completed an Aging in Place Needs Assessment Survey were categorized into four themes: need to downsize/home modification; need for assistance; family desire to reciprocate care; and isolation. A fifth group with no intent to relocate, but with concerns about having to, was also identified. Included among this group were persons with mental health or developmental disorders, such as anxiety and autism spectrum disorder. Results were examined through a person-centered lens to illustrate that aging in place may be the desired option even among residents who indicate that it is not. It is important that aging-in-place initiatives preserve identity by fostering a sense of autonomy, control, and well-being in older residents.     

Meaning as outcome: Understanding the complexity of decision-making around residential placement in aged care

Abstract

Changes in aged care and health policy have introduced an increasingly complex assessment, resource option, and economic and regulatory context for decision-making regarding relocation to residential care. This paper reports on a study exploring residential placement from the perspective of spouses who place a long-term partner in an aged care facility. It highlights the importance of understanding the meaning of such decision-making for the spouse who remains at home and explores the ways in which the placement is constructed as either a continuation of, or a refusal to, care for a long-term partner. The paper draws out the implications for social work practice and identifies the challenge to merge knowledge of resource packages, care options and financial arrangements with a concern with the processes of decision-making and the emotional and symbolic aspects of such decisions.     

Counter-maps of the ordinary: occupation,subjectivity, and walking under curfew in Kashmir

ABSTRACT

This article examines practices of resistance that thwart Indian state’s control over everyday life in Kashmir. The state frequently uses ‘curfew’ to dominate public space, shut down ordinary mobility, and suppress pro-independence politics. Curfews are enforced through punitive prohibitions and by activating the militarised infrastructure built to reinforce Indian rule over the region since 1947. Yet, Kashmiris are not passive objects of this control. Through overt and hidden practices of resistance and disobedience, like sangbāzi and, what I call, counter-mapping, they keep their aspirations for independence alive, while rebuilding a semblance of everydayness under the occupation. Desire to walk freely becomes the key metaphor for freedom from military control. Based on ethnographic and theoretical material, the article makes a case that in spaces under long-term military occupations political subjectivity is primarily expressed and enacted as a bodily demand to become visible in public space.     

Health and Well-Being for Late Middle-Aged and Old Lesbians in a Rural Area

Abstract

Previous research on lesbian health care has drawn primarily from samples of young lesbians living in metropolitan areas. Through face-to-face interviews with twenty-one lesbians aged 54 or older and living in rural communities, this exploratory, naturalistic inquiry begins to fill a gap in the literature by examining the health care experiences of older, rural lesbians. Five themes emerged from the narrative data: issues of access; good health/good care; open to her own diversity; family and community; and visions-ideals and fears. We present these themes through informant quotes and discuss implications for policy and practice.     

Ecstatic things

Abstract

This article addresses the orchestration of domestic lighting as an object of anthropological study. It takes Bedouin domestic architecture in southern Jordan as a starting point in an analysis of how light is used as means of safeguarding spaces as part of hospitality practices central to Bedouin culture. By arguing that things are “ecstatic” in the sense that they transcend their own tangibility, the article shows how objects, such as tinted windows, impose themselves on other objects to shape the particular visual presence of the world that informants opt for. Such a presence of the world is analyzed through the notion of “atmosphere” as a contemporaneity of subjective emotions, cultural ideals, and material phenomena. Thus, while boundaries between interior and exterior may be upheld by tangible material strategies, such as walls, these boundaries may also simultaneously be permeated by the ecstasy of material things, which aim to safeguard other aspects of life through less tangible strategies.     

Accumulating history: dirt,remains and urban decay in Nairobi

Abstract

In anthropology and related fields, “ruin” and “decay” are terms that are often used interchangeably. By paying close attention to the materiality and politics of dirt and decay in a colonial-era housing estate in Nairobi, Kenya, this article argues for their uncoupling. Instead of implying loss or oblivion, decay is explored as a process of accumulation: an excess that constitutes a material history. Remains, rubbish and dirt continue to be active in the present, effecting and constraining certain atmospheres, attitudes and politics. Drawing a distinction between “urban decay” as a policy category and as a material process, the article also considers what happens if these remains are wiped away in schemes of urban renewal. The loss usually associated with ruination may emanate not so much from decay as from its elimination.     

Symposium on political communication and social movements: audience,persuasion, and influence

ABSTRACT

This article argues that an important contribution that political communication can offer social movement studies is a more variegated understanding of social movement audiences and their role in social movement strategy and processes. Specifically, the article introduces a coarse typology of social movement audiences and discusses the importance of understanding differences in the goals of these audiences and what kinds of influence, from messaging or other forms of pressure, may be important to affect different audiences in movements’ favors. The article also examines the ways in which audiences are active, shaping what messages they are exposed to, consume, believe, and act upon. The call of the article is to bring a concern for audiences into social movement studies in the hopes of wedding these more media and communication-focused concerns with the kinds of structural and material influences social movement studies is so accomplished in investigating.     

The Use of Common Humanity Scenarios to Promote Compassion in Healthcare Workers

ABSTRACT

The importance of compassion in healthcare is universally acknowledged. However, the factors that enhance compassion are not well understood. The perception of common humanity has been proposed as a prosocial perspective that leads to unbiased universal compassion. There has been a lack of research into the relationship between common humanity and compassion. This study examined the use of common humanity scenarios to promote compassion in healthcare workers. Seventy-five healthcare workers were randomly assigned to two groups and shown a different common humanity scenario. The healthcare workers were asked what effect viewing the videos had on their perception of common humanity and compassion. Thematic analysis was used to identify themes. Four main themes emerged: (a) common bonds; (b) people have the same needs; (c) no one wants to suffer; (d) seeing strangers helping others is motivating. Healthcare workers reported feelings of care, concern, and compassion after viewing common humanity scenarios.

IMPLICATIONS

• Viewing common humanity scenarios appears to lead to enhanced feelings of connection to others and compassion in healthcare workers.

• Using common humanity scenarios may be a useful compassion training strategy in healthcare.

• Further research is necessary to gain a better understanding of how viewing common humanity material influences compassion.

     

Being a man in long term care

PurposeMen tend to represent a distinct minority in long term care (LTC) facilities. Here we explore men's seldom examined experience in LTC.Design and methodsAs part of a major study of Bereavement in Long Term Care, we focus on 21 men who live in five LTC facilities (assisted living facilities and nursing homes). Transcribed qualitative, in-person interviews are examined using standard qualitative analytic methods.ResultsThrough multiple rounds of coding three inter-related themes emerged as salient. (1) Men's work experience as central to their sense of identity. (2) The presence of a wife often is associated with men's sense of couplehood and of feeling protective. (3) Men often regulate their relationships with other LTC residents.ImplicationsDiscussion examines how these three themes are related to men's maintenance of a masculine role in LTC.     

“Live Social Work”: How to Bring Life Back into Social Work

Abstract

In this article I discuss how professional social work can entail critical, reflexive work. This is accomplished by adapting the concept of “live sociology”. It is mainly an exploratory article, trying to raise suggestions that can be adopted and be further developed. I argue that people coming into contact with contemporary social work are sometimes reduced to being “dead” objects, as they are pinned down into static categories. The demand for developing evidence-based social work risks substantiating this tendency even further. In contrast, I claim that social work needs to move away from these kinds of explanations and instead turn towards developing “live social work”; that is to say, social work where everyday life, agency, and what people do in what context needs to be the focus, not what people are.