| There are over 5.0 million people in the United States age 65 and older with a diagnosis of Alzheimer's disease and related dementias (ADRD). This number will increase dramatically as baby boomers age. Caregivers often become overwhelmed, resulting in transitioning a family member (FM) to an assisted living facility (ALF). As ADRD becomes more severe, caregivers may be faced with transitioning a FM to a memory care unit (MCU) to meet increasing needs. Yet, little is known about the transitioning process and how it might be different based on organizational structure of ALFs, or how different caregiver dyads experience these transitions.;My dissertation research examined the transition process from the perspective of administrators (N=37) in three different ALF-types: free standing ALFs, multi-level ALFs with an attached MCU (ALF plus MCU), and ALFs within continuing care retirement communities (CCRCs). My objective was to understand how the three ALF-types approach this situation. I also studied the decision-making process in transitioning from the community to ALFs and then to MCUs from the perspective of the caregiver (N=15), comparing three caregiver dyads: spouses, men-women, parent-adult child, to understand if these experiences differed. In-depth interviews were conducted. Grounded theory identified themes; thematic analysis organized content. The constant comparative method was used.;In the ALF-administrator study, results suggest many similarities and only a few differences between the three ALF-types: CCRCs used multidisciplinary approaches to transitioning, while ALFs plus MCUs used a dyadic approach; trial admissions were less common in CCRCs; free-standing ALFs discussed transfer policies during the admission process more frequently and encountered less resistance from families to transitioning. In the caregiver study, spouses found transitioning FMs to an ALF more difficult than adult children; adult children found the transition to the MCU more difficult than the initial move to the ALF. This suggests that the timing of support for spouses and adult child caregivers may be different. All found the MCU to be a favorable environment for FMs. Many suggestions for improving the transitioning process were provided by ALF administrators and caregivers that have implications for improving the transitioning process. |
