HOME HELP FEEDBACK SUBSCRIPTIONS ALL ISSUES SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chen, C. K. Articles by Barrick, A. L. Search for Related Content PubMed PubMed Citation Articles by Chen, C. K. Articles by Barrick, A. L.

Assisted Living Policies Promoting Autonomy and Their Relationship to Resident Depressive Symptoms

From Carolina Program in Healthcare and Aging Research, The University of North Carolina, Chapel Hill, NC.

Objective: The objective of this study is to determine the relationship between facility policies regarding autonomy and depression among residents of residential care/assisted living (RC/AL) facilities.

Method: A stratified sample of RC/AL facilities in Florida, Maryland, New Jersey, and North Carolina participated in the study. Patient characteristics for individuals 65 years and older were obtained from medical record reviews and in-person interviews. Facility administrators provided data on facility characteristics. Data on 1,098 residents were used to examine the relationship between facility policies as measured by domains of the Policy and Program Information Form and resident depressive symptoms and its factors as measured by the Cornell Scale for Depression in Dementia. Generalized estimating equation regression analysis was used to examine this relationship and control for other explanatory variables and clustering.

Results: Among the policy variables examined, only the degree to which residents were involved in facility administration was consistently associated with depressive symptoms. Greater resident influence over facility policies and involvement in facility administration was significantly associated with lower levels of depressive symptoms. Resident control over their daily activities, the facility's tolerance for disruptive behavior, and the extent to which facilities had formal mechanisms for defining expected behavior were not significantly associated with levels of depressive symptoms.

Conclusions: Although some facilities provide residents with opportunities to select activities or meal times, these policies were not associated with depressive symptoms. However, results are consistent with the hypothesis that resident involvement in facility administrative decision-making is associated with fewer depressive symptoms. Future research should explore the causal nature of this relationship and might provide guidance for policy and practice.

Key Words: Depression • long-term care