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This study examines the social environments, staff behavior, and social interaction of elderly clients in two adult day care centers. Goffman's (1961) description of the psycho-social effects of the "total institution" is used as a framework for conceptualizing the effects of "partial institutions" on older persons. Using qualitative research techniques, we observed the environments, activities, and interactions of approximately seventy-two clients in two adult day care settings. When the staff and environment were more infantilizing, provided less autonomy, and fewer opportunities for privacy regulation, the clients had lower social interaction with peers. In contrast, when the center had a more adult setting, with age appropriate activities, there was greater privacy regulation, autonomy, social contact, and friendships among clients.

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To prevent maltreatment, aging services must be age appropriate even as consumers suffer from physical and cognitive disabilities. In this paper, it is argued that exposing older persons to childoriented settings, activities and speech patterns in aging service environments represent a form of psychological mistreatment. Ethnographic evidence from 220 hours of field observations in five "social model" adult day centers revealed infantilization of service users in the form of confinement, baby-talk, nicknames, child-oriented decor, teacher-student learning format, reprimands, use of toys, as well as a loss of privacy regulation, autonomy, choice, and adult status. All centers exhibited some mistreatment, but severe examples were present in two of the five centers studied. Negative influences on behavior, well-being, self-identity, relationship formation, and social interaction were detected, which distinguished mistreatment from poor quality of care. Insider interviews (23) revealed resentment and adaptive strategies employed to distance themselves from infantilization.

This study uses a large, longitudinal national data set to examine sociological, feminist, and psychological perspectives to assess the level of intimate couple aggression and change in dyad aggression over time. The first multivariate analysis evaluates factors associated with the type of couple aggression (none, verbal, physical, or injurious), and the other analyzes predictors of change in severity of aggression that couples experience over time. Demographic variables, social integration, dependency, and psychological health measures are used to examine level of aggression and change over time. Sociological, feminist, and psychological perspectives are all supported to some degree by the results of this study, and we suggest a synthesis of these perspectives to explain the dynamics of couple aggression.