Aging in Place in Assisted Living: Exploring the Personal and Environmental Factors Related to Length of Stay

Abstract

This study examined to what extent personal and environmental factors, as defined by the contemporary ecological model of aging, help us understand aging in place in assisted living (AL). A review of the literature provided background on person-environment perspectives on aging in place as well as highlighted other studies of AL relevant to length of stay. A convenience sample (N = 218) of administrative records of AL residents admitted during between the years 2006 and 2011 was collected by the researcher from ALs located in Ohio operated by a single not-for-profit organization. Administrative records included AL residents’ demographic and healthcare information as well as dates of admission and discharge. Cox regression was used to determine which personal (biological, cognitive, affective, and health) and environmental (cultural, social, physical) factors influenced length of stay in three AL programs. Number of medical diagnoses, level of care score, and facility were found to be significant predictors of length of stay. The analyses identified a median survival time of 32 months as well as critical periods for discharge from AL. Using the ecological model of aging to examine length of stay in AL was supported. The results of this study will inform providers, policy makers, researchers, residents and their caregivers about the factors related to aging in place in AL. Study implications and future directions for research are presented.