Coming together and pulling apart: Exploring the influence of functional status on co-resident relationships in assisted living

Abstract

Social relationships can have considerable influence on physical and mental well-being in later life, particularly for those in long-term care settings such as assisted living (AL). Research set in AL 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. Functional status is a major factor influencing relationships, yet AL research has not studied in-depth or systematically considered the role it plays in residents’ relationships. This study examines the influences of physical and mental function on co-resident relationships in AL and identifies the factors shaping the influence of functional status. We present an analysis of qualitative data collected over a one-year period in two distinct AL settings. Data collection included: participant observation, informal interviews, and formal in-depth interviews with staff, residents, administrators and visitors, as well as surveys with residents. Grounded theory methods guided our data collection and analysis. Our analysis identified the core category, “coming together and pulling apart”, which signifies that functional status is multi-directional, fluid, and operates in different ways in various situations and across time. Key facility- (e.g., admission and retention practices, staff intervention) and resident-level (e.g., personal and situational characteristics) factors shape the influence of functional status on co-resident relationships. Based on our findings, we suggest strategies for promoting positive relationships among residents in AL, including the need to educate staff, families, and residents.

The incidence of depression among residents of assisted living: prevalence and related risk factors

“…Further, decline in the health of AL residents affects their relationships and interactions in daily life, and is a cause of isolation, separation from others, loneliness, and more severe manifestations of depression. 5 , 37 …”

“…The best practice inside the AL environment has been reported to emphasize on the ability of staff to recognize signs of depression and make early interventions, for which training is essential. 37 Previous research has found that residents in assisted care facilities suffering from depressive symptoms experience frustration with their careers’ limited abilities to effectively deal with depression. 9 , 45 Therefore, an interdisciplinary approach to raise awareness among staff for early recognition of the symptoms of depression among AL residents is recommended.…”

“…Family involvement at the admission stage is also important to better guide health care professionals in their identification of residents at risk for depression through the introduction of screening and intervention options to manage depression. 13 , 37 …”

Couples’ Social Careers in Assisted Living: Reconciling Individual and Shared Situations

“…Highlands transitioned from supportive to intolerant for cognitively impaired Mrs. Russell. This scenario, including shunning and social distancing, particularly in response to cognitive impairment and other frailties, affects all residents (Sandhu et al, 2013). Yet, couples' linked lives means the treatment of one affects both.…”

“…Reflecting the dynamism of relationships, residents engage in the process of "negotiating social careers in AL." Careers begin with the move and are negotiated over time, vary in content and nature, and are influenced by multilevel factors, including individual factors, such as functional status (see also Sandhu et al, 2013). Residents with spouses, siblings, or romantic partners have "built-in companionship."…”