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![]() 2008 Seniors Housing & Care Journal Abstracts
Abstract This report describes the development of a new tool that objectively evaluates senior living environments. The principles were based on the established psychosocial needs of residents, using the concept of environmental "affordances" (the actions or
behaviors supported by a given environment). The 63-item instrument, developed
from the existing environmental design literature, received validity testing in a
recent multiregional study conducted at 68 randomly selected Assisted Living facilities
(1,569 respondents). Researchers' environmental ratings significantly correlated
with resident questionnaire responses on most items. The environmental evaluation
tool also found high rates of inter-rater and test-retest reliability in preliminary testing.
By making environmental evaluations more quantifiable and reliable, it
becomes possible to compare health- and satisfaction-related outcomes associated
with physical environments. This instrument may serve as a useful example for
developing future tools to assess physical environments for seniors.
Abstract The shortage of direct-care workers in nursing homes is projected to grow due to
shifts in labor markets, aging of the workforce, and sociodemographic changes.
Providers can implement more effective strategies to improve employee job satisfaction
by understanding what underlies it. This paper reveals and
quantifies factors that predict job satisfaction among workers in nursing homes, specifically associated with worker attributes (gender), characteristics of the job
or role (shift worked and job tenure), characteristics of the facility (percent
Medicaid, size, geographic region, and staffing ratios), and leadership competencies
(focused visionary, supporting change, communication, strategic management, and
caring leadership). Together, these factors account for 52% of the variance in global
satisfaction. We find that leadership competencies are strongly associated with job
satisfaction, and we recommend that aging services professionals focus on leadership
competencies and workforce development as key initiatives to sustain quality
improvement efforts in nursing homes.
Abstract In the past 20 years, Erickson Retirement Communities has been developing Continuing
Care Retirement Communities (CCRCs) in an increasing number of markets.
Its CCRC developments have caused existing providers in these and future
Erickson target markets to question how their own communities will be affected.
The Erickson Impact study surveyed existing providers in four market regions in
which Erickson Retirement Communities have been developed, including both
mature and nascent markets, to determine the effects Erickson communities have on existing communities. The results suggest that communities are making
changes as competition increases, but most senior living providers do not attribute these decisions to the presence of an Erickson community.
Mature markets that may have been deemed "saturated" with seniors
housing have demonstrated that they can successfully absorb a significant number
of new units. Strong performers, in particular, see no decrease in occupancy rates or
waiting lists.
Abstract The desire for older adults to "age in place" is a growing trend. Housing developers
will be able to better market to older adults if they understand why older adults
choose to leave a single-family home and move into apartments, townhouses, and
condominiums. Marketers also need to understand how older Americans decide
between facilities. In this paper, we report the results of a national study designed to
examine older consumers' current housing choices, as well as their preferences for
future housing via the use of a previously published segmentation tool that
describes the mature consumer market. The results indicate that "healthy indulgers"
are the most viable market segment for apartments, townhouses, or condominiums.
Marketing strategy should focus on their needs for locational convenience, security,
and access to public transportation.
Abstract This research identified changes in availability and access to Assisted Living (AL)
facilities for Medicaid-enrolled older adults in a Midwestern state from 1999 to
2004. While more facilities accepted Medicaid residents in 2004, there was no statistically
significant increase in the percent of AL residents who received Medicaid
waiver services, and many facilities had self-imposed waiting lists. Furthermore,
room and board costs for waiver residents increased 114 percent. Large facilities and facilities
in metropolitan areas were less likely to accept Medicaid-enrolled older adults
than were small- or medium-sized facilities or those in non-metropolitan communities.
AL facility respondents reported reluctance to participate in the Medicaid
waiver program because of low reimbursement rates and excessive paperwork. More
research is needed to identify and evaluate promising state and federal initiatives to
address barriers that may lead to Medicaid-enrolled older adults' premature admission
to nursing facilities.
Abstract The evolution of age-restricted active-adult communities has been occurring over
the past 40 years. As Baby Boomers approach traditional retirement years, their
lifestyles and preferences also are beginning to affect not only the physical amenities
of these communities, but also the social and cultural options being offered to
meet Boomers' expectations. This paper provides findings from an evidence-based
demonstration project in four active-adult communities in the southwest. The
demonstration was intended to bring new models of lifelong learning and civic
engagement inside these active-adult communities in order to look at the impact on
resident connection to both the internal and external community.
Abstract The purpose of this exploratory study was to develop a comprehensive wellness assessment for older adults. It analyzed data from 259 paper surveys received from
community- and senior living-based older adults in the Tucson, Arizona, and
Chicago, Illinois areas. They provided responses to Likert scales and open-ended questions
about satisfaction with life; wellness activities; rating of well-being, self-efficacy, and
readiness for behavior change in each of six wellness dimensions; level of help and
support desired in each dimension; as well as an overall rating of well-being.
Statistical analyses of the 100-item, five-construct survey were conducted to confirm
that it is a valid and reliable tool. The findings revealed that the emotional and
social dimensions had the strongest relationship with overall life satisfaction.
Implications for those serving older adults are discussed.
Abstract The purpose of this study is to promote environmental support for senior independence
and confirm the existence of research evidence relating to it, including
site-level environmental correlates of elderly falls and active behavior that is defined
as daily activities, physical activities, and social interactions. Applicable settings
range from individual to group living arrangements. A review-based analysis of
peer-reviewed English-language literature was completed to identify and analyze
qualitative and quantitative studies investigating the aforementioned environmental
correlates. Literature reviews and unpublished works were not included. The population
group of interest was older adults with good cognitive functioning.
Thirty-one studies were included. A research agenda was created to summarize previous
research and identify gaps. Design guidelines were noted in relation to
building and site design. Considerable opportunities exist for use of site-level environmental
interventions to promote active behavior and prevent falls among older
adults. More research is required to link studies for a better understanding of environmental
influences on senior independence.
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