Perceived Decisional Control as a Mediator between Moving to Assisted Living Due to Caregiver Burden and Relocation Adjustment.

ABSTRACT

Objectives

The rapid growth of the older population in the United States has led to increased utilization of assisted living facilities (ALFs), and it is important to understand what factors may facilitate better adjustment. This study examined the mediating role of perceived decisional control in the relationship between moving to assisted living (AL) to prevent/alleviate caregiver burden and post-relocation adjustment.

Methods

Participants were 91 newly-transitioned residents of ALFs in Alabama and Maryland. Data were gathered through in-person interviews and questionnaires. Mediation analyses were done using the PROCESS macro for SPSS, applying 5,000 bootstrap resamples with 95% bias-corrected confidence intervals estimated around the indirect effect.

Results

The effect of moving to AL to prevent/alleviate caregiver burden on post-relocation depression and socialization was indirect and dependent on the degree of perceived decisional control.

Conclusions

Perceived decisional control may be a key factor in adjusting to AL, even when the move is catalyzed by such a complex and emotionally laden construct as caregiver burden.

Clinical Implications

Greater perceived decisional control over potential relocation may facilitate better adjustment, and other parties involved in the decision-making process should strive to involve the older adult in question in this process to the greatest extent possible.

KEYWORDS:

• Perceived decisional control
• assisted living
• life transitions
• burden
• adjustment
• aging
• older adults
• long-term care

Clinical implications

• Perceived decisional control may be an important factor in how older adults will adjust when moving to assisted living.

• Advance planning for scenarios in which an older adult may want to relocate, such as for the prevention of caregiver burden, may increase control over potential relocation destinations and facilitate better adjustment.

• Family members or care providers should strive to maximize the input of the older adult who may be relocating.

Acknowledgments

We thank Stephanie Lichtenstein and Tyler Thompson for their assistance with data collection. We are indebted to the assisted living residents who shared their time and experiences with us.

Disclosure statement

No, potential conflicts of interest were reported by the authors.

Data Availability Statement

The data that support the findings of this study are available from co-author, NGR, upon reasonable request.