Bringing assisted living services into congregate housing: residents' perspectives.

Abstract

Bringing state-subsidized assisted living services (ALS) into congregate housing (CH) is a strategy for reducing rates of nursing home placement. This article discusses CH residents' reactions as a new ALS program was introduced in their housing, and it provides recommendations for others who are considering the implementation of similar programs. Focus groups and face-to-face interviews with residents in a CH facility explored their experiences over time with the new ALS program. Residents were interviewed before the program was initiated and 6 months later as a way to better understand their knowledge of and feelings about the program. A qualitative analysis of the interview data revealed several patterns of complex attitudes and emotions linked to the program. Although the overwhelming majority of residents endorsed the program as a way to avoid nursing home placement, few understood the features of the program (e.g., cost and eligibility requirements). ALS participants' accounts of services suggested the presence of a highly "medicalized" approach. When new community-based models are implemented for elders, policy makers need to evaluate how these programs affect quality of life. Further, program guidelines for bringing ALS into existing housing have to address how the program complements the home-like nature of the housing.