| Policy Studies and Applied Research | ||
| General Publications and Research Topics | The Occasional Long Term Care Policy Paper Series | LTC Advances Newsletter |
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<back Assisted Living Housing Research At Preiss-Steele Place in Durham, North Carolina by Stephanie Fonda, MA Doctoral Candidate in Sociology, Duke University Duke Long Term Care Resources Program (Duke LTC) October 1996 For the past three years, Duke LTC has been involved in a project with the Durham Housing Authority and the Department of Social Services to determine whether low-income older adults at risk of illness and impairment can benefit from relocation to the benign environment of an assisted independent living facility. The relatively poor health and high mortality of low socioeconomic groups has been the subject of sociological and social epidemiological inquiry for over forty years, yet it is still unclear to what extent and in what ways psycho-social factors, such as residential context, influence these outcomes. Further, theories of person-environment fit posit that the interaction between the elderly and their settings impacts individual well-being, but few efforts have been made to examine how this interaction affects the association between socioeconomic status and health. In 1993, Duke LTC began to address issues such as these by observing the residents and environment of the first assisted living facility for low-income adults in Durham, N.C. - Preiss-Steele Place. To meet these objectives, two instruments were used to characterize Preiss-Steele residents before they move into the facility and every six months thereafter: The Duke Service and Outcomes Screen (SOS), and the N.C. Community Alternatives Program (CAP) assessment. These instruments were chosen because they were already being used throughout the community to gather information on clients needing or receiving supportive services. In addition, they contain questions that are comparable to those found in representative surveys of older adults, such as the National Long Term Care Survey, and the Established Populations for Epidemiological Studies of the Elderly. Ultimately, we hope to document the Preiss-Steele resident's trajectories of health, functioning, and service utilization and compare them to those found among a representative sample of low income adults living in the community. In addition, we characterized the living environment of Preiss- Steele Place annually between 1993 and 1996. To do this, we used the Multiphasic Environmental Assessment Procedure (MEAP), an instrument developed by Rudolf Moos and Sonne Lemke to observe nursing homes and other settings for the elderly. So far, Moos and Lemke have used the MEAP to characterize over 262 facilities and have identified which aspects of those environments affect resident outcomes. Again, we selected this instrument with an eye toward future comparisons. In sum, Preiss-Steele Place constitutes a naturally occurring setting for monitoring how low income, at-risk, older adults age in place within a specific living environment. It affords us the opportunity to examine whether an environmental intervention will make a difference in the well-being of low-income older adults. Can contemporaneous factors make a difference or are the cumulative effects of a lifetime of low socioeconomic status too powerful to mitigate? Note: a published report on the first year at Preiss-Steele Place is found in the Journal of Applied Gerontology ( December 1996). back to top |
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