Factors of Social and Physical Environment for De-Institutionalization

Kyoungmee Byun (University of Louisville)

Institutionalization as a critical life event for care recipients (CR) and their family caregivers (CG) may lead to financial burden and negative outcomes such as increased mortality and restricted quality of life and care. Many studies show that most older adults wish to stay in their homes as long as possible. Additionally, living in their homes provides continuity in the environmental experience of the person which is beneficial to their quality of life and independence. Older adults greatly value their independence in daily activities and engagement which leads to greater life satisfaction in their community.

As people get older, they have a higher level of increasing attachment to their living areas through sensitivity to their social and physical environments. Attention to sense of community and person-centered home modifications may matter more to older adults and might play an important role for de-institutionalization, a shift from institutions to the community. As the population of older adults grows in the U.S., institutions may not be able to keep up.

However, while predictors of institutionalization such as age, functional and cognitive status, and depressed feeling among older adults have been well studied, few studies have paid attention to the roles of CG variables in CR senses of community and person-centered home modifications, the focus of this study.

This study was based on secondary analysis of cross-sectional data drawn from the National Study of Caregiving (NSOC) and first and third waves drawn from National Health Aging and Trend Study (NHATS) with 846 CGs and 846 CRs. Binary logistic regression analysis was used to identify respective characteristics for institutionalized and community dwelling older adults. As a result, the significant associations among social/physical environments, CG variables and institutionalization will be addressed to contribute to de-institutionalization.