The problem of this study is to compare prior health care experience with satisfactory adjustment in a long-term care facility. Both quantity and quality of prior experience in a health care facility are examined in terms of the significance to successful relocation. Demographic data and perceived control of health are examined in relation to significance of the findings.

Ethnically diverse older adults are the fastest growing population in the U.S. This population may experience transitional processes associated with immigration, acculturation, aging, and end of life (EOL). Advances in technology lead to increases in care options, which can cause uncertainty to make decisions for EOL. Unmade decisions about care prior to becoming unable to communicate are associated with burdens of last-minute decisions at EOL, unwanted intensive EOL treatments for people who may die naturally of old age, financial and emotional costs, and decreased quality of life. In the U.S., a multicultural country with a variety of care options, advance directive (AD) completion and advance care planning (ACP) may improve culturally competent and person-centered care at EOL. However, the rate of AD completion and ACP is low among Americans, especially immigrant communities. These communities, including Iranian-American older adults, have been frequently understudied, and there is a gap in studies of EOL desires, attitudes, and actions/behaviors. This inquiry focused on planning ahead for EOL care across transitional processes that older immigrants may face. The aim was to enhance culturally competent care for older adults through distinguishing significant factors, which may influence planning for EOL care. Specific purposes were: To identify relationships between attitudes toward planning for EOL care and social supports, spirituality, healthcare system distrust, and acculturation; to identify a relationship between attitudes and proactive actions toward planning ahead in Iranian-American older adults. Conceptual frameworks for this descriptive, cross-sectional study included Culture Care Diversity and Universality and Transitions theories. Findings from 135 participants revealed that they were new immigrants to the U.S. (mean year of 23 in the U.S., 97% born in Iran) and highly educated and insured with high health statuses. About 55% preferred non-intensive treatments and/or homecare at EOL, and 52.6% had not communicated their EOL wishes. Attitudes toward planning ahead for EOL were positively associated with acculturation and healthcare system distrust, and negatively associated with spirituality. No significant association was found between attitudes and social support. Furthermore, favorable attitudes predicted higher proactive actions to communicate wishes. Implications for practice, policy, education, and recommendations for further studies were discussed. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection

This project explored the values considered by elderly people, their younger relatives, and health professionals in decisions about residential long - term care, aiming to contribute to the literature on prospectively held values. The mixed methods design utilised a medical record review of 60 frail elderly hospital patients, a stratified survey of 3,015 adults in the South Australian community, and interviews with 36 stakeholders ( 10 elderly people, 10 younger relatives, and 18 health professionals ). The medical record review confirmed that the hospital patients and their outcomes resembled those described internationally. It was used to develop a hypothetical vignette, used in the later studies. Survey responses suggested that when considering a hypothetical long - term care decision, community members put the elderly person ' s physical health and safety first. Situational variables ( the elderly person ' s autonomy, environmental adaptation, and caregiver burden ) appeared secondary, albeit less so with increasing age of the respondent. Thematic analysis of the interviews demonstrated that elderly stakeholders considering a hypothetical decision were more likely to mention autonomy values, and less likely to mention safety values, than were relatives or health professionals. However, elderly stakeholders were also more likely to suggest restrictive solutions, such as residential placement and proxy decision - making. This finding raised methodological issues concerning ' third person ' vignettes, in that respondents might be responding as proxy decision - makers, rather than as if the hypothetical decision applied to themselves. The project confirmed that, in this context, prospectively held values resembled the retrospectively described values identified by McCullough, Wilson, Teasdale, Kolpakchi and Shelly ( 1993 ). Hence, the retrospective literature could be applied. The project supported the importance and complexity of psychosocial predisposing factors when applying the Andersen Behavioral Model ( Andersen, 1995 ) to long - term care decisions. Additionally, the Ecological Theory of Aging ( Nahemow, 2000 ) and the MacArthur Model of Successful Aging ( Andrews, Clark, & Luszcz, 2002 ) were found to be relevant to long - term care decisions for individuals and populations. It was concluded that both clinically, and at a policy level, discussions of long - term care could be more effective if they focussed on maintenance of elderly people ' s autonomy and control, rather than on their physical health and safety. / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2006.

The Best PhD Thesis in the Faculties of Architecture, Arts, Business & Economics, Education, Law and Social Sciences (University of Hong Kong), Li Ka Shing Prize, 2003-2005. / published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

This project explored the values considered by elderly people, their younger relatives, and health professionals in decisions about residential long - term care, aiming to contribute to the literature on prospectively held values. The mixed methods design utilised a medical record review of 60 frail elderly hospital patients, a stratified survey of 3,015 adults in the South Australian community, and interviews with 36 stakeholders ( 10 elderly people, 10 younger relatives, and 18 health professionals ). The medical record review confirmed that the hospital patients and their outcomes resembled those described internationally. It was used to develop a hypothetical vignette, used in the later studies. Survey responses suggested that when considering a hypothetical long - term care decision, community members put the elderly person ' s physical health and safety first. Situational variables ( the elderly person ' s autonomy, environmental adaptation, and caregiver burden ) appeared secondary, albeit less so with increasing age of the respondent. Thematic analysis of the interviews demonstrated that elderly stakeholders considering a hypothetical decision were more likely to mention autonomy values, and less likely to mention safety values, than were relatives or health professionals. However, elderly stakeholders were also more likely to suggest restrictive solutions, such as residential placement and proxy decision - making. This finding raised methodological issues concerning ' third person ' vignettes, in that respondents might be responding as proxy decision - makers, rather than as if the hypothetical decision applied to themselves. The project confirmed that, in this context, prospectively held values resembled the retrospectively described values identified by McCullough, Wilson, Teasdale, Kolpakchi and Shelly ( 1993 ). Hence, the retrospective literature could be applied. The project supported the importance and complexity of psychosocial predisposing factors when applying the Andersen Behavioral Model ( Andersen, 1995 ) to long - term care decisions. Additionally, the Ecological Theory of Aging ( Nahemow, 2000 ) and the MacArthur Model of Successful Aging ( Andrews, Clark, & Luszcz, 2002 ) were found to be relevant to long - term care decisions for individuals and populations. It was concluded that both clinically, and at a policy level, discussions of long - term care could be more effective if they focussed on maintenance of elderly people ' s autonomy and control, rather than on their physical health and safety. / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2006.

Thesis (M.Sc.)--Memorial University of Newfoundland, 2004. / Includes bibliographical references.

This exploratory study sought to identify factors which motivate individual participation in volunteer services for the Long-Term Ombudsman Program of the Volunteer Center of Riverside County.

published_or_final_version / Social Work / Master / Master of Social Work

This thesis explores the relationship between the needs people experience in later life and the types of care they receive. The thesis provides evidence on the role of different types of care in supporting the needs of people aged 60+ in England using the English Longitudinal Study of Ageing (ELSA). The research presented adopts a number of new approaches to capturing the multi-dimensional nature of dependency by utilising a range of binary indicators of difficulty performing 10 actions related to upper and lower body mobility, 6 activities of daily living (ADL) and 7 instrumental activities of daily living (IADL). The thesis provides a detailed analysis of the prevalence of these items when considered independently and collectively in combination. A central aim of the research is to develop a more nuanced understanding of dependency to allow for the dimensionality of the needs experienced by older people living in their own homes to be considered. The thesis utilizes a number of different approaches, including simple binary and count-based indicators of need and more complex measures reflecting dependency across different domains of need. These approaches allow a more dynamic picture of dependency in later life to be considered. Using these measures, the research explores the role of different types of care in meeting different types of need. Of these, a unique application of an existing assessment tool is presented, the Indicator of Relative Need (IoRN), which is used as a framework to derive an equivalent measure – the Array of Need (AoN). Given the aim of the study is to investigate the multi-dimensional nature of dependency, various data reduction approaches are used including principal components analysis. Finally, research from similar studies is acknowledged and work from the Survey of Health, Ageing and Retirement in Europe (SHARE) study is reproduced using ELSA. The thesis suggests that when considering the dependency needs experienced by older people living in the community, it is important to be aware that this group includes both less and more dependent older people. As such, developing a better understanding of the dynamic relationship between dependency and the receipt of informal and formal care may require more suitable measurements of dependency.

This study examined the influence of three predictor variables on perceptions of assisted living: psychological well-being, functional status, and coping strategies. A multiple regression analysis was used to examine the influence of these factors on perceptions of the transition to assisted living.