Abstract:
The decision to transition to long-term care profoundly affects the lives of older adults, yet they often play a limited role in the decision-making process or are excluded altogether. This finding is alarming, as the adverse effects of low perceived control on adjustment to long-term care are well-documented. The present study examined the association of perceived decisional control with older adults' well-being and adjustment to an assisted living facility. These outcomes were then examined within the framework of the well-known and validated metamodel, Selective Optimization with Compensation (SOC; Baltes & Baltes, 1990). Specifically, the current study assessed whether or not the indirect effects (via perceived decisional control) of contributing factors to relocation on measures of adjustment and well-being were impacted when new assisted living residents focused their resources on whatever goals were deemed most important, realistic, and helpful in adapting to the environment. In a sample of 91 newly-transitioned assisted living residents in Maryland and Alabama, perceived decisional control was significantly associated with moving for reasons related to safety, caregiver burden, health, and capacity for independent living. Perceived decisional control partially mediated the effects of safety, caregiver burden, and health on acceptance; safety, caregiver burden, and health on negative affect; safety and caregiver burden on depression; and safety, caregiver burden, and health on socialization. Additional results partially support the moderating role of SOC strategies on the strength of indirect effects of several predictor variables on outcomes post-relocation. Overall, SOC adaptations appear to promote adjustment and well-being to relocation at various levels of perceived decisional control.
