Document Type

Thesis - University Access Only

Award Date


Degree Name

Doctor of Philosophy (PhD)

Department / School



Designed to reflect the comforts and much of the privacy of an individual's home, the assisted living facility promotes vitality, participation, socialization, and maintenance of a sense of purpose and dignity by generally providing for physical, spiritual, and emotional needs. When older persons become frail or infirm and are no longer able to live alone safely, or are having difficulties with living independently, the assisted living facility becomes a viable alternative. This research looks at the role assisted living plays in continuum of care services for older frail adults and explores the process of making a decision to move by older frail persons from their traditional living environments to ones of assisted living. Exploratory and descriptive, this qualitative research investigates little understood phenomena, discovers and identifies important variables, and generates hypotheses for further research. Data come from a variety of data sources. Twenty-two residents of seven assisted living facilities are interviewed, as well as a family member, the administrator of the assisted living facility, and a social worker connected with the case. Assisted living facility records and promotional materials are reviewed. In an attempt to gain a thorough understanding of assisted living in South Dakota, interviews were conducted with six professionals including state and local representatives of the Departments of Health and Social Services. Government publications contained much of the needed information. The assisted living data gathered are not available in any one published format. An orienting model is developed to guide the research. Elements of the model are (1) the nature of the situation-precipitating factors; (2) the individual actor; (3) social resources; (4) economic resources; (5) context, including social services, housing types and availability, other options, time constraints, and amount of information; and (6) situation assessment and awareness. Three new themes evolved from this research including altered notions of aging about frail older persons, selection by longevity, and continued independence vs. dependence. The research generated over a dozen ideas for further research. It is important to compare the experiences of older frail persons who have not made a decision to move in similar circumstances to those in the study. A study might by conducted which addresses how high uncertainty with a present living situation might affect perceptions of future consequences. Further work needs to be done in the area of social behavior of persons who are aging without diminished cognitive capacity. A potential exists for tapping the resource of accumulated knowledge and wisdom amongst even the "oldest of old."

Library of Congress Subject Headings

Older people -- Housing -- South Dakota
Frail older people -- Care -- South Dakota
Congregate housing -- South Dakota



Number of Pages



South Dakota State University