Design for a Longitudinal Study of the Impact of an Enhanced Environment on the Functioning of Frail Adults

Abstract

The article documents the development of an assisted living facility for low to moderate income, frail, older adults in Durham, North Carolina, and describes the research plan designed to assess longitudinally the impact of this facility on the functioning of its residents. The backbone of the conceptualization and development of this facility is an ongoing cooperative relationship among a research team at Duke Umversity's Center for Aging, the Durham Housing Authority, the Durham Department of Social Services, and related community agencies. These researchers and practitioners also worked together to create the research plan, which consists of characterizing resident health and functioning every 6 months using the Service Outcome Screen and the Community Alternatives Program assessment and characterizing the environment annually with Rudolf Moos' Multiphasic Environmental Assessment Procedure. Finally, this article reports preliminary observations about this new assisted living facility, including features of its environ ment and aggregate characteristics of its residents, and discusses future plans for monitoring their functional status and comparing them to older adults in other settings.

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References

Carp, F.M. , & Carp, A. (1984). A complementary/congruence model of well-being or mental health for the community elderly. In I. Altman , J. Wohlwill , & M. P. Lawton (Eds.), Elderly people and the environment (pp. 279-336). New York: Plenum .

Faletti, M.V. (1984). Using technology to adapt environments. Generations, 8, 35-38.

Fillenbaum, G.G. (1988). Multidimensional functional assessment: The Duke Older Americans Resources and Services Procedure. Hillsdale, NJ: Lawrence Erlbaum.

Fillenbaum, G.G. , & Smyer, M.A. (1981). The development, validity, and reliability of the OARS Multidimensional Functional Assessment Questionnaire. Journal of Gerontology, 36, 428-434.

Gill, T.M. , & Feinstein, A.R. (1994). A critical appraisal of the quality of quality-of-life measurements. Journal of the American Medical Association, 272, 619-626.

Kahana, E. (1982). A congruence model of person-environment interaction . In M. P. Lawton , P. G. Windley , & T. Byerts (Eds.), Aging and the environment (pp. 97-121). New York: Springer.

Kane, R. , & Wilson, K.B. (1993). Assisted living in the United States: A new paradigm for residential care for frail older persons? Washington, DC: American Association of Retired Persons.

Lawton, P.M. (1985). The elderly in context: Perspectives from environmental psychology and gerontology. Environment and Behavior, 17, 501-519.

Lawton, P.M. (1991). A multidimensional view of quality of life in frail elders. In J. B. Birren , J. B. Lubben , J. C. Rowe , & D. B. Deutchman (Eds.), The concept and measurement of quality of life in the frail elderly (pp. 3-27). New York: Academic Press.

10.

Lawton, P.M. , & Nahemow, L. (1973). Ecology and the aging process. In C. Eisdorfer & M. P. Lawton (Eds.), Psychology of adult development and aging (pp. 619-674). Washington, DC : American Psychological Association.

11.

Moos, R.H. (1980). Specialized living environments for older people: A conceptual framework for evaluation. Journal of Social Issues , 36, 75-94.

12.

Moos, R.H. , & Lemke, S. (1992). Multiphasic environmental assessment procedure manual. Palo Alto, CA: Center for Health Care Evaluation, Department of Veterans Affairs, Stanford University Medical Centers.

13.

Moos, R.H. , & Lemke, S. (1994). Group residences for older adults. New York: Oxford University Press.

14.

North Carolina Department of Human Resources. ( 1996). General statute 131-D. Raleigh: Author.

15.

Preiss, J.J. (1993). Getting it together: Developing assisted independent living housing in Durham. Long-Term Care Advances, 4, 1-9.

16.

Wilson, K.B. (1990). Assisted living: The merger of housing and long-term care services. Long-Term Care Advances, 1, 1-11.