Assisted living is a growing option for housing/care of older adults with cognitive or physical limitations. Interest has turned to assuring quality for residents, but little research has examined what quality means to the older adults living there. This study investigates the meanings of quality in four stakeholder groups (residents, resident kin, direct care staff, and administrators) in 9 Assisted Living (AL) facilities. Rather than assume that quality is a known and commonly-understood concept, it is taken as problematic in this study. A major goal is to elucidate the specific elements that constitute the various models of quality, variation of these elements among residents, and the degree to which the three other stakeholder groups define quality differently.
Specific aims i nclude: 1) eliciting the essential elements of the meaning of quality among residents via interviews; 2) examining these models for variation by sex, race/ethnicity, functional status, and tenure in the facility; 3) To examine the meanings of quality in other stakeholder groups (i.e. AL administrators, direct care staff and resident families) through: a) interviews to elicit elements of AL resident quality from their perspectives, and b) prioritizing elements of quality derived from the residents' narratives. 4. To have AL residents determine (via card sort) the extent to which elements attached to their definitions of quality are commensurate with those emerging from other stakeholder groups. Ethnographic interviews will be employed to collect the elements of subjective meaning of quality, which will be subject to a rigorous team-based collaborative coding process. Results will serve as input for a card sort procedure that will establish the degree to which definitions vary among residents, are commensurate across groups, and the elements that are most central to quality definitions of each stakeholder group. Findings will provide a strong validity base for development of quality assessment tools in AL inclusive of the critically important voice of residents and inform both policy development and practice in this sector.
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