Quality of Life for Diverse Older Adults in Assisted Living: The Centrality of Control

Abstract

This pilot project asked: How do ethnically diverse older adult residents of assisted living (AL) facilities in British Columbia (BC) experience quality of life? And, what role, if any, do organizational and physical environmental features play in influencing how quality of life is experienced? The study was conducted at three AL sites in BC: two ethnoculturally targeted and one nontargeted. Environmental audits at each site captured descriptive data on policies, fees, rules, staffing, meals, and activities, and the built environment of the AL building and neighborhood. Using a framework that understands the quality of life of older adults to be contingent on their capability to pursue 5 conceptual attributes-attachment, role, enjoyment, security, and control-we conducted 3 focus groups with residents (1 per site) and 6 interviews with staff (2 per site). Attributes were linked to the environmental features captured in the audits. All dimensions of the environment, especially organizational, influence tenants' capability to attain the attributes of quality of life, most importantly control. Although many tenants accept the trade-off between increased safety and diminished control that accompanies a move into AL, more could be done to minimize that loss. Social workers can advocate for the necessary multi-sectoral changes.

Multiple Linear Regression-Structural Equation Modeling Based Development of the Integrated Model of Perceived Neighborhood Environment and Quality of Life of Community-Dwelling Older Adults: A Cross-Sectional Study in Nanjing, China

“…To the physical neighborhood environment, perception of the street connectivity is associated with the wellbeing of older adults [13]. Barrier-free design [14,15], the condition of sidewalks, the placement of crosswalk [16], and the street noise level [17] all have great influences on the QoL of older adults. Regarding the social neighborhood environment, studies have pointed out that social cohesion and social support significantly influence the wellbeing [13] and QoL [18,19] of older adults.…”

“…In safety aspect of neighborhood environment, neighborhood safety affects physical activities [7] and the overall QoL [18] of older adults. Security [16] is closely associated with the QoL of older adults. Health-related QoL of older adults is heavily influenced by the safety from traffic [17] and crime [14].…”

“…Many community-dwelling older adults need to walk outdoors every day, and, without the "pedestrian-and-vehicle dividing system", they have to walk along the sidewalk [39]. A better sidewalk condition with an even surface, enough width, and sidewalk for the blind has positive impacts on their sense of control [16], makes them feel more relax, and benefits their psychological health. Thus, the sidewalk condition should be attended to if older adults are to be more active physically [5].…”

How the Urban Neighborhood Environment Influences the Quality of Life of Chinese Community-Dwelling Older Adults: An Influence Model of “NE-QoL”

“…In addition, older adults prefer to walk rather than cycle or drive within neighborhood, thus, as one of the most important walkable transportation infrastructures, the sidewalk is an infrastructure which older adults heavily rely on. The sidewalk condition, like surface evenness, width and blind sidewalk, can decide a sense of control of older adults [27], and then influence their psychology.…”

“…Besides, there is significant research focusing on the neighborhood environment of older adults and their QoL, like overall QoL, health-related QoL and social life. Neighborhood safety, social cohesion [24], social support [25], barrier-free design [26], security, control, accessibility, condition of sidewalks and placement of crosswalk [27] are neighborhood environmental factors which are closely associated with overall QoL of older adults. The safety from traffic, walking level, safe parks, street noise level [28], aesthetics, physical barriers and crime [29] impact on health-related QoL of older adults, while the distance to the nearest green space or senior center are regarded as non-significant factors to health-related QoL of older adults [30].…”