Assisted living means to undergo drastic changes in life. Most significant is the change from a familiar domestic environment to a care based situation that includes incremental levels of medical support, often in spaces that are modeled after hospitals. The core of this thesis is grounded in the believe that an architectural familiarity of space should be retained, whereas the overall architecture should be able to silently absorb the necessities of medical support. As a place of habitat, the constellation of rooms proposes for an individual to quickly develop a new community that analogous to the typical domestic communities. / Master of Architecture / The population of the elderly is very large in today's society, which results in urgent needs of assisted living institutions. But some design of assisted living institutions tend to be similar to hospitals, which can not provide comfortable living environment for the elderly. Therefore, the thesis focus to find a possible way for the assisted living institution design to meet both the medical needs and the living needs of the elderly. The main idea is to build a small community for the elderly where they can have their daily life as usual and to provide necessary medical care which will be separated from the living part.

Using findings from a statewide study of satisfaction and retention of 294 direct-care staff in 39 assisted-living facilities (ALFs) in Georgia, this study examines the effect of sociodemographic, job, and attitudinal characteristics on overall job satisfaction and its various dimensions. The results show age has a negative effect on promotion satisfaction. Whites are more satisfied than non-whites with overall job, work, supervision, and pay. Urban workers are less satisfied with overall job, supervisor, coworker, promotion, and pay than their rural counterparts. Education negatively affects coworker satisfaction. Workers with children are less satisfied with supervisor relationships, and pay than childless persons. Pay is positively associated with pay satisfaction. Perceived workload is negatively associated with overall job satisfaction and each of its dimensions. Finally, perceived autonomy is positively associated with promotion satisfaction. The results of this study emphasize the need for new strategies to improve job satisfaction among workers in ALFs.

The United States is experiencing a rapid rise in its citizens aged 85 and older, which is the fastest growing segment of the population. By the year 2050 the population of adults 65 years old and older is predicted to double in size. This trend, referred to as the graying of America, has been a catalyst for researchers eager to fill gaps in appropriate housing options for this population. For the past decades assisted living has grown as such an option for senior housing. The purpose of this study was to design an assisted living private dwelling unit based on criteria found in literature and in the findings of two research projects. Data were collected during site visits to five assisted living facilities as part of the Best Practices study. Data collected during the CAVE study, in which participants expressed preferences toward assisted living apartment designs, were also utilized. Design criteria emerging from both studies were found to be in support of current literature. A design concept employing these criteria was developed. The design was presented through graphic techniques including plans, elevations and isometric drawings. / Master of Science

Class of 2009 Abstract / OBJECTIVES: To assess a student pharmacist administered osteoporosis education program given to assisted living facility staff members in order to evaluate the impact of the program on the staffs’ knowledge and attitudes about osteoporosis treatment and prevention. METHODS: The study consisted of a pre-test/post-test design to evaluate data obtained through surveys administered at assisted living facilities in the Phoenix, Arizona area. The primary dependent variables were knowledge and confidence levels of the staff in regards to osteoporosis management. The surveys included multiple choice questions that measured knowledge of osteoporosis prevention and treatment, as well as Likert-scale questions to measure confidence levels. Mean scores were calculated and paired t- tests were used to compare scores of pre-test versus post-test answers. RESULTS: Surveys were completed by 5 participants. Sixty percent of the staff members were female and the mean age was 36 years old (SD 9.90). Eighty percent of the sample were certified nurse assistants. The mean pre-test score for the knowledge portion of the survey was 3.6 and the mean post-test score was 4.8 (p=0.18). The mean pre-test score on the participants confidence levels was 11.2 and the mean post-test score was 11.8 (p=0.37). Overall, the participants rated the value of the program a mean of 7.6 out of 8 possible points. CONCLUSIONS: Although not statistically significant, knowledge and confidence levels of osteoporosis management were raised in assisted living facility staff members after a student pharmacist administered presentation on the subject.

Class of 2009 Abstract / OBJECTIVES: The objective of this study was to determine the effect of an education program in regards to pharmacy students’ knowledge and confidence regarding osteoporosis management. METHODS: This was a pretest/posttest study of data obtained through surveys given to pharmacy students’ at the Phoenix and Tucson campuses. The education program administered was generated by the Arizona Osteoporosis Coalition. RESULTS: A total of 19 pharmacy students were surveyed in Tucson and Phoenix, AZ. When the knowledge questions were analyzed (questions 1 through 7), the t-score obtained was 4.7914 (p<0.05). This score was larger than the t-critical value for a 95% confidence interval. When the confidence questions were analyzed (questions 8 through 10), the t-scores obtained were 0.6849, 0.5945, and 0.2287, respectively. These scores did not reach statistical significance (p>0.05). The intervention proved to increase knowledge but did not increase confidence. CONCLUSIONS: The education program on osteoporosis management increased pharmacy students’ knowledge on this disease state. Other education programs targeting various disease states may also increase students knowledge, further preparing them to provide quality patient care.

Incidents of falls among the elderly increase with age. About $31 million is spent annually in the United States on medical costs related to fall injuries in the elderly. This project evaluated the outcomes of a fall reduction program implemented in an assisted living facility (ALF). The Stop Elderly Accidents, Death & Injury program developed by the Centers for Disease Control and Prevention was implemented by the ALF for 60 days prior to the outcome evaluation project. The program included a convenience sample of 62 residents and involved medication evaluation, exercises, assistive devices, environmental risk reduction, and evaluation of blood pressure. Bandura's theory on self-efficacy was applied in guiding the implementation process. The practice-focused question compared the fall rate among the ALF's elderly residents during the 30-day period following implementation of the program, and the previous 12months. The fall rates were analyzed with descriptive statistics. Results showed the preintervention fall rate was 6.6 falls per month, while at the end of the 30-day postimplementation period, that rate was reduced by 39.4% to 4 falls per month. The conclusion of this outcome-evaluation project is that falls among the elderly in the ALF can be reduced with evidence-based programs. The recommendation is that ALFs should have fall reduction programs, thereby avoiding unnecessary complications of falls among elderly residents. Implications for nursing practice include improved understanding of falls as a safety issue for ALF residents and the need for nurse practitioners to take a more active role as advocates for fall prevention programs in ALFs. The positive societal change produced is improved safety and reduction in fall injuries among the elderly in assisted living facilities.

Social relationships can have considerable influence on physical and mental well-being. AL research suggests that other residents are among the most available social contacts and that co-resident relationships can affect life satisfaction, quality of life, and well-being. Although functional status influences social relationships, research has yet to provide an in-depth understanding of how cognitive and physical function affects co-resident relationships in AL. In this thesis, I present an analysis of qualitative data collected over a one-year period in two diverse settings. The thesis addressed: 1) How does functional status influence co-resident relationships? ; and 2) What factors shape its influence? Analysis was guided by principles of Grounded Theory Method. Coming together and pulling apart signifies the key finding that functional status is multi-directional, fluid, and operates in different ways in various situations and across time. Facility and resident –level factors further affect the influence of functional status on co-resident relationships.

Syftet med denna studie är att kartlägga eventuella risker och möjligheter med sensorteknik som hjälpmedel inom vård och omsorg. Studien använder en kvalitativ metod med kvantitativa inslag där semistrukturerade intervjuer tillsammans med frågeformulär utnyttjades. Åtta personer med olika eventuella relationer till sensortekniken intervjuades och resultatet har visat på att både risker och möjligheter kan ses. Studien visar att vad respondenterna kan anse användbart att sensortekniken utför eller hjälper till med, inte nödvändigtvis ses som acceptabelt. Den visar även på att personal och ledning inom vård och omsorg inte alltid är överens om t.ex. hur mycket utbildning av personalen som behövs vid införande av ny teknik eller hur kvalitén på utbildningen är. De gemensamma åsikter som framkom var hur viktig och betydelserik teknik som t.ex. sensortekniken kommer bli för den framtida vård och omsorg för att kommunerna ska kunna tillgodose det ökade behovet.   Studien bidrar till en djupare förståelse för attityder gentemot sensortekniken och kan vara som en vägledning för kommuner vid införandet av liknande tekniker i framtiden. Genom att lyfta fram de olika rollernas eventuella tankar och idéer om sensortekniken kan det användas som en form av kravanalys, sett utifrån ett operativt perspektiv till fördel för framtida forskning i ämnet. Det kan också underlätta för kommuner, genom att peka ut vart och hur rädslor och negativitet gentemot tekniken kan finnas, för att kunna förebygga med hjälp av ytterligare information till personal, användare och anhöriga.

In this thesis, new computer vision based techniques are proposed to detect falls of an elderly person living alone. This is an important problem in assisted living. Different types of information extracted from video recordings are exploited for fall detection using both analytical and machine learning techniques. Initially, a particle filter is used to extract a 2D cue, head velocity, to determine a likely fall event. The human body region is then extracted with a modern background subtraction algorithm. Ellipse fitting is used to represent this shape and its orientation angle is employed for fall detection. An analytical method is used by setting proper thresholds against which the head velocity and orientation angle are compared for fall discrimination. Movement amplitude is then integrated into the fall detector to reduce false alarms. Since 2D features can generate false alarms and are not invariant to different directions, more robust 3D features are next extracted from a 3D person representation formed from video measurements from multiple calibrated cameras. Instead of using thresholds, different data fitting methods are applied to construct models corresponding to fall activities. These are then used to distinguish falls and non-falls. In the final works, two practical fall detection schemes which use only one un-calibrated camera are tested in a real home environment. These approaches are based on 2D features which describe human body posture. These extracted features are then applied to construct either a supervised method for posture classification or an unsupervised method for abnormal posture detection. Certain rules which are set according to the characteristics of fall activities are lastly used to build robust fall detection methods. Extensive evaluation studies are included to confirm the efficiency of the schemes.

The assisted living industry is predicted to experience considerable growth due to the simultaneous aging of the baby boom generation and their subsequent need for long-term care. This study investigates individuals’ pathways to administration in assisted living and the ways in which assisted living administrators define and carry out their roles. The study contributes to the understanding of the knowledge, skills, and personal traits needed by those who assume these vital leadership roles in an industry poised to care for the bourgeoning population of older adults. The sample for this study is 44 administrators who work in a random sample of 45 assisted living facilities in Georgia. Qualitative methods were used to analyze the data. The data revealed that multiple multi-level factors not only facilitate an administrator’s pathway to AL administration, but these factors also help to shape how an administrator experiences his or her role within an ALF.