LITERATURE REVIEW

Care Home Residents Experiences Of the Transitional Phase Of A Move Due To A Care Home Closure

Care Home Residents Experiences Of The Transitional Phase Of A Move Due To A Care Home Closure

An extensive literature critiquing the nature of long-term care provision for older people has developed during the past 60 years (e.g. see Townsend 1962? Robb 1967? Willcocks et al. 1987). However? this literature says little about the role and needs of family caregivers within the context of long-term care. Most studies of nursing home entry and care have focused on the experience of residents and staff? while the needs of family members at this time have received far less attention. In particular? few studies have gathered qualitative data on relatives'experiences of helping a family member to move into a nursing home and on the ways in which they establish a new role within this context. Temporal models of caregiving suggest that family caregivers pass through a series of stages during their caregiving career? and that? when they assist an older person to move into a nursing home? they enter a new but still involved stage during which they are likely to require support to achieve a smooth transition (Aneshensel et al. 1995? Nolan et al. 1996). However? there is little research evidence indicating the type of support that will be most effective during this often difficult period.

As the American population ages? the demand for senior housing and long-term care also increases. Currently? 1.4 million older adults live in nursing homes? with more than 900?000 in assisted-living residences (Association for Homes and Services for the Aged [ASHA]? 2007). The continuing care retirement community (CCRC) has emerged as another option for senior living. Continuing care retirement communities permit residents to remain in one facility? while moving between levels of care as their needs require: independent living (IL)? assisted living (AL)? and nursing living (NL; Matthews? 2002). There are currently about 2?240 CCRCs in the United States (ASHA)? and the number of older adults living in CCRCs has more than doubled in the past decade: from 350?000 in 1997 (Scanlon & Layton? 1997? p. 1) to 745?000 in 2007 (ASHA).

Most older adults prefer to "age in place?" staying in familiar locations (Frank? 2002? p. 2)? and CCRC administrators emphasize this goal? but the social divide between levels of care in CCRCs means considerable environmental discontinuity for residents who move. Indeed? the CCRC concept (i.e.? different levels of care in one facility) implies that transitions will take place. The primary aim of this research was to investigate how residents perceive transitions across levels of care and how they manage social relations while moving within a CCRC. Research has shown that moving into a CCRC enhances older adults' social engagement (Heisler? Evans? & Moen? 2004)? but studies have not explored how moving within a CCRC affects social integration. The overarching research question is as follows: What individual perceptions and shared meanings do residents develop for transitions?

To investigate transitions within CCRCs? I examine two ...