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Assisted Living Transitions: Experiences of Family Members of Older African American Women

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Assisted Living Transitions: Experiences of Family Members of Older African American Women Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2021 Assisted Living Transitions: Experiences of Family Members of older African American women Carol A. Shaw Burns Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Family, Life Course, and Society Commons, and the Feminist, Gender, and Sexuality Studies Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Social and Behavioral Sciences This is to certify that the doctoral dissertation by Carol Shaw Burns has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Barbara Benoliel, Committee Chairperson, Human Services Faculty Dr. Jan Ivery, Committee Member, Human Services Faculty Dr. Dorothy Scotten, University Reviewer, Human Services Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2021 Abstract Assisted Living Transitions: Experiences of Family Members of Older African American Women by Carol Shaw Burns MPA, Roosevelt University, 2001 BS, Northern Illinois University, 1995 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Human Services Administration Walden University February 2021 Abstract Long-term care, also known as aging services, is evolving to meet the needs of the aging population in the United States, which is increasingly ethnically and racially diverse. The objective of this qualitative multiple case study was to understand how immediate family members experienced the transition of older African American women as they moved into assisted living facilities. Black feminist theory provided a theoretical framework. Narrative interview data were collected from four adult children family caregivers who facilitated the move. Three themes emerged from the content analysis: (a) Transition is not planned in advance and does not happen until a critical event or incident occurs that changes the older adult’s physical, social, or emotional status; (b) The transition was more difficult than had been thought for the older women and their families; and (c) Older adults expect that family members stay connected and involved after the transition, and family members may have similar expectations. Human services professionals may use the results to provide better-informed programs and services for older African American women and their family member caregivers. Social change implications suggest developing a transition model to improve assessment and evaluation processes, promote cultural competence initiatives, and promote a person-centered approach to the transition process in order to begin to identify a framework that might be useful for human services practitioners. Assisted Living Transitions: Experiences of Family Members of Older African American Women by Carol Shaw Burns MPA, Roosevelt University, 2001 BS, Northern Illinois University, 1995 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Human Services Administration Walden University February 2021 Dedication I want to dedicate this dissertation to my loving husband, Marlon. He has always been my cheerleader, the person I look to for encouragement, advice, and support throughout my dissertation journey. I want to thank him for his patience, understanding, and flexibility, especially during those many days, evenings, and weekends where I needed to focus on course assignments and other related projects to pursue my doctoral degree. I have to say that you have given me strength, motivation, and tenacity because of your positive attitude, insightfulness, and thoughtful perspective. Marlon Bruce Burns, you are my rock. I adore, love, and appreciate you beyond words. Thank you for everything, my LOVE. Acknowledgments First, I would like to acknowledge all the older adult clients with whom I have worked over the last 25 years in the field of aging services. Each one I have encountered throughout my career has inspired me to advocate to improve, enhance, and support the programs and services offered to this population. I also want to acknowledge my mother, Alva Nora Shaw, sisters, Angela and Karen, brother, Andrew, nephew, Justin, and husband, Marlon, for their unwavering support, encouragement, and guidance throughout my doctoral pursuit. Each contributed in different ways, resulting in the successful completion of my studies and now my dissertation. I cannot forget to mention my loving father, Ambrose Vivian Shaw. Even though he is no longer with us, he continues to guide me. Daddy, I love and thank you always! And lastly, I must thank my chair, Dr. Barbara Benoliel, and my dissertation committee members, Dr. Jan Ivery and Dr. Dorothy Scotten, for their guidance, recommendations, and expertise. It gave me comfort to know that I had support at Walden, especially when I had questions, experienced challenges, or setbacks during the rigorous process of completing my dissertation. Walden University is fortunate to have scholar-practitioners that are competent, knowledgeable, and supportive. Table of Contents List of Tables .......................................................................................................................v Chapter 1: Introduction to the Study ....................................................................................1 Background ....................................................................................................................2 Problem Statement .........................................................................................................5 Purpose of the Study ......................................................................................................9 Central Research Question and Subquestions................................................................9 Theoretical Framework ................................................................................................10 Nature of the Study ......................................................................................................14 Definitions....................................................................................................................15 Assumptions .................................................................................................................17 Scope and Delimitations ..............................................................................................18 Limitations ...................................................................................................................20 Significance..................................................................................................................21 Summary ......................................................................................................................22 Chapter 2: Literature Review .............................................................................................24 Literature Search Strategy............................................................................................26 Theoretical Foundation ................................................................................................27 Transitioning to Assisted Living ..................................................................................31 Autonomy and Independence ............................................................................... 34 Decision-Making................................................................................................... 35 Family Member Caregivers .................................................................................. 38 i Quality of Life in Assisted Living ........................................................................ 41 Diversity in Assisted Living ................................................................................. 42 Successful Aging .................................................................................................. 44 Social Ties and Social Isolation ............................................................................ 48 Health Perceptions ................................................................................................ 50 Cultural Competence ............................................................................................ 52 Summary ......................................................................................................................55 Chapter 3: Research Method ..............................................................................................57 Research Design and Rationale ...................................................................................58 Role of the Researcher .................................................................................................60 Methodology ................................................................................................................62 Participant Selection ............................................................................................
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