Choice,Control, and Adaptation Among Elderly Residents of Sheltered Care Settings1

This study examined how elderly residents' adaptation is affected by naturally occurring levels of choice and control in sheltered care facilities. A representative sample of 244 residential care facilities was assessed with the Multiphasic Environmental Assessment Procedure, which measures the quality of residential settings for older people. Overall, facility policies allowing more choice and control were associated with better rated resident well-being, less use of health, daily living assistance, and social-recreational services, and more integration in the community. Policy clarity and the facility social climate factors of independence, influence, and organization mediated the relationship between choice and control and adaptation, and also independently affected residents' adaptation. In addition, in facilities with functionally able residents, more choice and independence were associated with less use of services; in facilities with residents of poor functional ability, choice and independence were unrelated to use of services. Thus, policies that promote more choice and independence may improve adaptation among functionally able residents of sheltered care facilities, without having a detrimental influence on poorly functioning residents.     

Measuring the social climate of congregate residences for older people: Sheltered Care Environment Scale

We developed the Sheltered Care Environment Scale (SCES) to provide researchers and practitioners with a practical means of assessing the social climate in congregate residential settings for the elderly. The SCES, a 63-item yes/no questionnaire that can be completed by residents and staff members of a facility, taps their perceptions of seven dimensions of the social environment. These dimensions concern the quality of relationships, the personal growth orientation present in the facility, and maintenance and change of the social system. The SCES discriminates among settings, has moderate to high internal consistency and split-half reliability, and is sensitive to environmental change against a backdrop of relative stability over time. The SCES reflects actual, agreed-on qualities of a setting and is relatively unaffected by characteristics of the respondent. Normative data are available from a national sample of 244 facilities representing the variety of residential settings available to the elderly.     

Validity of the Sheltered Care Environment Scale: conceptual and methodological issues

The Sheltered Care Environment Scale (SCES) was developed primarily to measure social climate as an attribute of a setting. As such, the SCES was designed to maximize differences between facilities and minimize differences among individuals within a setting. However, Smith and Whitbourne (1990) assessed the validity of the SCES as a measure of individual differences in perceptions of a shared environment. Moreover, they redefined the content coverage of 2 of the SCES subscales (Independence and Physical Comfort), to encompass attributes the SCES is not intended to measure. In general, preliminary evidence indicates that the SCES subscales provide reasonably reliable and valid indices of the social climate of group residential facilities.     

Life stressors, social resources, and late-life problem drinking

Life stressors and social resources among late-middle-aged problem and nonproblem drinkers were studied. Problem drinkers (n = 501) reported more negative life events, chronic stressors, and social resource deficits than did nonproblem drinkers (n = 609). In a comparison of problem drinkers, men reported more ongoing stressors involving finances and friends, and fewer resources from children, extended-family members, and friends than did women. Women who are problem drinkers reported more negative life events, more ongoing difficulties with spouses and extended-family members, and fewer resources from spouses. Among both the problem and nonproblem drinkers, more stressors were associated with fewer social resources, but only within certain life domains. Late-middle-aged adults' chronic stressors and social resources helped explain their drinking behavior, depression, and self-confidence even after sex, marital status, and negative life events were considered.     

Understanding environments: The key to improving social processes and program outcomes

The contributions to this Special Issue illustrate research on several important types of environmental units, including psychiatric and substance abuse treatment programs, neighborhood block groups, and entire communities. They also exemplify alternative methodologies, such as assessing environments by relying on participants' appraisals, external observers' ratings, historical archives, and direct observation. I draw on these contributions and some of my own work to discuss four recurrent issues: (a) how to conceptualize environmental domains and dimensions; (b) how to understand environmental dynamics, that is, the interplay of environmental factors both within one setting and across settings; (c) how to comprehend the processes that link environmental factors to outcomes, especially with respect to the power and evanescence of environmental influence; and (d) how to use information about environments to monitor and improve them. Increased knowledge in these four areas is essential to help fulfill a major aim of community psychology: to understand social processes and improve intervention program outcomes.     

Environmental Choice and Control In Community Care Settings for Older People1

This study focuses on the long-term stable levels of environmental choice and control available in community care settings, and explores how variations in these factors affect elderly residents of such settings. New methods to evaluate naturally-existing levels of policy choice and resident control are developed and applied to a representative sample of residential care facilities. The findings showed that residents with more functional resources, and women residents, were inore likely to live in facilities high in choice and control, and that these personal and environmental factors were associated with better resident functioning and more cohesive, independence-oriented social environments with relatively little conflict. Functionallyable residents reacted more positively to high control and women residents reacted more positively to high choice. Investigators who attempt to manipulate perceived control in institutional settings need to consider the existing opportunities residents have to exercise control, as well as the levels of other relevant personal and environmental resources.