Skip Navigation


The Gerontologist Advance Access originally published online on June 2, 2009
The Gerontologist 2009 49(4):463-473; doi:10.1093/geront/gnp063
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
49/4/463    most recent
gnp063v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Carder, P. C.
Right arrow Articles by Schumacher, J. G.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Carder, P. C.
Right arrow Articles by Schumacher, J. G.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Understanding the Intersection of Individual Needs and Choices With Organizational Practices: The Case of Medication Management in Assisted Living

Paula C. Carder, PhD1, Sheryl Zimmerman, PhD2 and John G. Schumacher, PhD3

2 School of Social Work, Program on Aging, Disability and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
3 Department of Sociology and Anthropology, Center for Aging Studies, The Erickson School, University of Maryland, Baltimore County

1 Address correspondence to Paula C. Carder, PhD, Institute on Aging, Portland State University, P.O. Box 751, Portland, OR 97207. E-mail: carderp{at}pdx.edu


  Abstract

Purpose: Making choices about everyday activities is a normal event for many adults. However, when an adult moves into an assisted living (AL) community, making choices becomes complicated by perceived needs and community practices. This study examines the relationship between choice and need in the context of practices, using medication administration practices as the case in point. Design and Methods: A 5-year ethnographic study collected information from 6 AL settings in Maryland. Ethnographic interviews (n = 323) and field notes comprise the data described in this article. Results: AL organizations used practice rationales based on state regulations, professional responsibility, safety concerns, and social model values to describe and explain their setting-specific practices. The result was varying levels of congruence between the setting's practices and individual resident's needs and choices. That is, in some cases, the resident's needs were lost to the organization's practices, and in other cases, organizations adapted to resident need and choices. These findings suggest that individuals and organizations adapt to each other, resulting in practices that are not bound by state requirement or other practice rationales. Implications: AL residences vary due to both internal and external forces, not just the public policies that define them. State regulations need to be responsive to both the needs and the choices of individual residents and to the people who work in an AL.

Keywords: Needs, Congruence, Choices, Assisted living facilities, Ethnography, Grounded theory

Received November 10, 2008; Accepted February 23, 2009

Decision Editor: Nancy Schoenberg, PhD


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.