Assisted living (AL) facilities have developed rapidly as a viable living option for older adults who seek an intermediate setting for long-term care (Meyer, 1998; Zimmerman et al., 2003). Although researchers have begun to turn their attention to AL (Zimmerman et. al, 2003; Eckert et. al, 2001; Hawes, Phillips & Rose, 2000), many critical dimensions of these environments remain inadequately defined and poorly understood. In particular, systematic analysis of the practice, perceptions, and role of physicians caring for AL residents remains an important gap in our understanding of AL Therefore, the general aim of the proposed study is to examine and document the role that physicians play in health care delivery and decision-making regarding the admission, retention, transfer and on-going health care for AL residents. The four specific aims are: 1) To examine the range of physicians' practices with AL; 2) To explore physicians' perceptions of AL resident transitions; 3) To examine physicians' perspectives on AL facilities and process of care; and 4) To integrate physicians' perspectives with the parent study's findings on AL residents transitional histories Data collection will consist of ethnographic interviews (El) and surveys with physicians of 50 current AL residents living in a range of AL facility types (small, traditional, and new model) in Maryland. The physician EIs and brief survey will collect demographic information and global measures of physicians' perceptions and practice toward AL (e.g., involvement with the admission process, frequency of visits with resident, contact with facility staff). The physician interviews will run 30-45 minutes and will be tape recorded and transcribed. The study will be competed within a one year. The study is framed by several broad postulates derived from preliminary analysis of data from the parent study. Outcomes of this research include developing educational interventions, improving clinical care, and sharpening questions and hypotheses for further research. The inclusion and integration of physician level data regarding AL residents, care practices, and transitions will facilitate a richer and more comprehensive understanding of the complexities involved in AL resident transitions and represents an unparalleled opportunity to systematically contribute to the knowledge base in the area. ? ?
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