A Mixed-Method, Time Series Analysis of Resdient Satisfaction and Well-Being in a Rural Assisted Living Facility for Low-Income Elderly

Sandra S. Butler
School of Social Work
University of Maine
5770 Social Work Building
Orono ME 04469-5770
(207) 581-2382
FAX: (207) 581-2396
sbutler@maine.edu
 
James Gomon
Community Health and Counseling
42 Cedar St.
Bangor ME 04401
(207) 947-0366
Purpose:  The Assisted Living (AL) model of care has gained considerable popularity in the last 10 years, although development has been largely restricted to urban/suburban regions and costs remain prohibitive for low-income elders.  Recently there has been considerable controversy surrounding how to regulate AL and whether facilities meet the health, safety and social needs of their residents.  The purpose of this study was to examine, from their perspective, the experiences of AL for low-income rural individuals.

Method:  A three-staged, 12-month time series analysis of the inaugural cohort (n=29) entering a rural AL facility for low-income individuals in a northeastern state was utilized to follow the experiences of residents during the first year in their new home.  Time I interviews were composed of open-ended questions resulting in rich narrative data about the transition from their former lives into the community setting.  Time II and III interviews assessed resident satisfaction, level of independence, contact with family, and overall well-being.  Both qualitative (thematic analysis of narrative data) and quantitative (e.g., chi-squares, t-tests and matched pairs t-tests) data analyses were conducted.

Results: Themes which emerged from Time I narratives underscore the overriding significance of a set of contradictory emotional responses (relief, sadness, anxiety, excitement, and resigned acceptance) at the point of AL entry.  Time II and Time III data confirm heightened satisfaction with the facility and increased feelings of independence in the first year of residence, although the AL experience was less positive (p<.01) for men.

Implications: Recommendations include increased programming with men's needs in mind, greater access to transportation for external activities, and clearer lines of communication between the residents and facility administration.  While financial worries continued to plague many residents, the availability of this state-subsidized facility clearly fills a need for some rural, low-income elders.