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«Megan Lee for the degree of Doctor of Philosophy in Design and Human Environment presented on November 12, 2008. Title: Aging in Place: A ...»

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AN

Abstract

OF THE DISSERTATION OF

Megan Lee for the degree of Doctor of Philosophy in Design and Human Environment

presented on November 12, 2008.

Title: Aging in Place: A Contemporary Social Phenomenon

Abstract approved:

Carmen D. Steggell

Most aging individuals prefer to remain in a self-determined home environment,

and generally aging adults want to remain in the same home or same community. The benefits of remaining in a self-determined private home environment while aging have been established. Because individuals present a diversity of needs, it takes interdisciplinary and multifaceted approaches with options to keep older adults in their communities. Aging in place (AIP) represents an interdisciplinary approach to creating options that facilitate remaining in a self-determine environment. The purpose of this research was to examine the current state of the interdisciplinary concept aging in place (AIP). The need to understand AIP is more globally relevant as the U.S. becomes an aging society facing rapid change due to technology, globalization, and mobility. Guided by the tenants of theory development, and the ecological model of housing choice, two manuscripts were developed focusing on the current state of AIP. The first research study titled, An Evolutionary Concept Analysis: Aging in Place, used the content analysis method to examine the concept across diverse disciplines. A derived definition was developed that includes research, practice, policy, and those individuals involved in the aging process. The definition reflects the contemporary state of AIP and can be used for theory development and to unify all users of the AIP concept. The second research study titled, The Current State of Older Women Aging in Place in Oregon, used qualitative case study methods to examine seven cases of aging in place. The aim of the project was to examine seven women’s current and past experiences, and the dynamic process of aging in place in a self-determined private home environment. Two common themes were identified (1) The AIP reflects the woman’s process of self-preserving actions that maintain current AIP independence, and (2) AIP situational independence suggests that the participants’ pathways to their current AIP began after they each experienced an individualized trigger event. The findings have theoretical and practice implications that provide a comprehensive and interdisciplinary approach to identifying the current status of AIP and the development of options that facilitate the AIP process.

©Copyright by Megan Lee November 12, 2008 All Rights Reserved Aging in Place: A Contemporary Social Phenomenon by Megan Lee

A DISSERTATION

submitted to Oregon State University

–  –  –

Presented November 12, 2008 Commencement June 2009 Doctor of Philosophy dissertation for Megan Lee Presented on November 12, 2008

APPROVED:

Major Professor, representing Design and Human Environment Chair of the Department of Design and Human Environment Dean of the Graduate School I understand that my dissertation will become part of the permanent collection of Oregon State University libraries. My signature below authorizes release of my dissertation to any reader upon request.

–  –  –

Thank you to Dr. Carmen Steggell for your years of mentorship. The journey through the program and dissertation was made possible with your unwavering support.

Thank you to Dr. Atiya Mahmood for your generous mentorship over the years and exposure to the environment-behavior paradigm that has greatly influenced the dissertation.

Thank you to Dr. Mark Edwards who has been an instrumental source of support and exposure to the sociological paradigm that has greatly influenced the dissertation.

Professor Carol Caughey was instrumental in influencing my decision to attend graduate school at Oregon State University. I will always be grateful for the crossing of our paths.

Thank you to Dr. Chris Ward for your generous service on my committee as the graduate representative.

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Manuscript Two (Chapter Three) – The Current State of Older Women Aging in Place in Oregon……………………………………………………… 11 Purpose of Study …………………………………………………… 11 Rationale for Journal Selection …………………………………….. 11 Relationship to Overall Purpose ……………………………………. 12 Brief Description of Method ……………………………………….. 12 Research questions ………………………………………….. 12 Sample ………………………………………………………………. 13 Primary case study participants ……………………………… 13 Supportive case study participants …………………………… 13 Data collection ……………………………………………….. 13 Data Analysis ………………………………………………………… 13

TABLE OF CONTENTS (Continued)

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Narrative analysis …………………………………………... 14 Summary …………………………………………………………………… 14





MANUSCRIPT ONE (CHAPTER TWO) – An Evolutionary Concept Analysis:

Aging in Place ………………………………………………………………. 16

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Introduction ………………………………………………………………… 18 Background …………………………………………………………………. 19

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Method ……………………………………………………………………… 28 Procedure …………………………………………………………… 28 Evolutionary Method Activity #1: Identification of Concept………… 29 Evolutionary Method Activity #2: Selection of Setting and Sample… 29 Sample ……………………………………………………… 29 Criteria for inclusion and exclusion of resources …………... 30 Databases Described ………………………………………………… 31 Academic Search Premier …………………………………... 31 AgeLine ……………………………………………………... 32 Google Scholar ……………………………………………… 32 CSA Sociological Abstracts …………………………………. 33 Evolutionary Method Activity #3 and #4: Data Collection …………. 34 Definitions …………………………………………………… 34 Antecedents ………………………………………………….. 34 Consequences ………………………………………………… 35 Surrogate terms ………………………………………………. 35 Related concepts ………………………………………………35

TABLE OF CONTENTS (Continued)

Page

Evolutionary Method Activity #5: Data Analysis Using Content Analysis ………………………………………………….. 35 Data analysis of definitions ………………………………. 35 Data analysis of attributes ……………………………….... 36 Data analysis of antecedents and consequences ………… 36 Data analysis of surrogate terms, related concepts ……… 36 Evolutionary Method Activity #6: Conduct Interdisciplinary or Temporal Comparison, If Needed ………………………. 36 Discipline or field of origin ……………………………… 36 Evolutionary Method Activity #7: Identify a Model Case if Appropriate ……………………………………………. 37 Evolutionary Method Activity #8: Identify Implications for Future Development ……………………………………………… 37 Data analysis and implications of results ………………… 37 Internal validity as inter-rater reliability …………………. 37 Results ……………………………………………………………………. 38 Definition of Terms ………………………………………………. 38 Sample Description ………………………………………………. 38 Year of resource publication ……………………………… 38 An international interest, eight countries in sample …….... 38 Type of housing or innovation …………………………… 39 Types of resources, scholarly or non-scholarly ………….. 40 Discipline or trade of author(s) ………………………….. 40 Unidentified disciplines or trades of author(s) …………... 41 Definition of Aging in Place ……………………………………………… 41 Aging in Place Defined Explicitly ……………………………….. 42 The Defining Characteristics of the Explicit Definitions ………… 42 Aging in Place Defined Implicitly ……………………………….. 44 Summary of AIP Definition ……………………………………… 44 Operational Definition of Aging in Place ………………………... 44 Is AIP a Concept, Phenomenon, Philosophy, or Trend? ………… 46 Attributes …………………………………………………………………. 47 A Paradigm Shift Toward an Evolving Social Phenomenon of Aging in Place …………………………………………… 47 Demographic changes and pressure …………………….. 48

TABLE OF CONTENTS (Continued)

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Balance of Innovative Parts Support AIP ………………………………… 52 Top Down Innovative Actions and Options ……………………… 53 AIP related policy ………………………………………… 54 Programs, Services, and Products ………………………………… 56 Services …………………………………………………… 56 Services to programs ……………………………………… 57 Products …………………………………………………… 58 Summary of Top Down Innovations, Actions, and Options ……… 59 Collaboration of Multiple AIP Contributors …………………….. 60 Twelve categories of diverse disciplines and/or trades in sample ………………………………………….. 61 The various types of interdisciplinary collaborations ……. 61 Interdisciplinary collaborations for applied policy, care, service, program, and/or product development and implementation ……………………………………. 62 Interdisciplinary collaborations for basic and applied research, development, and education …………….. 63 The collaboration occurring within family units ………….. 64 Summary of Collaborations of Multiple AIP Actors ………………66 Independence is Empowerment, Empowerment is Independence …66 Shared aging in place responsibility ……………………... 67 Prevention as a problem solving option ……………………67 Individual’s empowerment options ……………………….. 69 Summary of Independence is Empowerment, Empowerment is Independence ……………………………………………... 71 Antecedents and Consequences …………………………………………… 71 Antecedents ………………………………………………………. 72 Consequences ……………………………………………………... 73 Derived Definition of AIP as a Contemporary Social Phenomenon ……… 74

TABLE OF CONTENTS (Continued)

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