Transferring Control ~ From Living in the Community to Assisted LIving

I found a fascinating article in the September 2013 issue of Journal of Applied Gerontology.    This study was funded by the National Institute on Aging. 

 

The participants included 77 older adults, and they resided in various types of assisted living facilities in Maryland.  Researchers Leslie A. Morgan and Michael A. Brazda, from the University of Maryland, Baltimore County, conducted open-ended interviews regarding transfer of control over life tasks.  The issue of transferring control is under-investigated, thus, often misunderstood or perceived as negative. 
 

They found that appointed or proxy transfers were positive, while transfers that were “unwanted” or “taken from” them were negative.  Overhelping and underhelping were also perceived as negative.  

 

It is important for adults to maintain as sense of control, autonomy, and mastery over their lives.  Other losses, or tasks of aging, may occur simultaneously when older adults are in declining health and must move from the community into assisted living.  Loss of a spouse, loss of friends, loss of status, looks, pets, and finances occur at the same time as diminishing physical, cognitive, and social resources.  Maintaining a sense of control is essential to wellbeing and life satisfaction.

 

When older adults move into assisted living for increased level of care, family members, close friends, family, and extended family usually help oversee care, manage money, manage disposing of property and furnishings, and manage medical care. 

 

The Morgan and Brazda (2013) study found that of the 77 participants, 16 chose their assisted living facility.  This proactive approach was described as positive: The older adults who chose their facility described feeling in control of their situation.  The study also found that proxy control resulted in positive outcomes.  Proxy control is relinquishment of some personal control to an intermediary to help achieve specific desired outcomes.  Among the participants, when proxy control was exercised, they expressed empowerment in the face of diminishing capacity.   

Proxy control was not always given to grown children.  Some of the participants who had grown children chose others including close friends, neighbors, in-laws, extended family [quasi-family], and siblings.  One older man without children chose his baby brother as proxy.  A retired schoolteacher without children chose her “adopted granddaughters,” former students now in their 50’s who helped her choose the assisted living facility, settle in, dispose of some furnishings, and move in.  She gave financial proxy to her longtime friend.   Another participant spoke to his lawyer first and then gave proxy control to his daughter-in-law. 

 

Older adults who made an active choice to delegate by proxy expressed a sense of control and mastery over their lives.  However, older adults who perceived that control was “taken” or “seized” from them had negative reactions about their living arrangements and preferences. 

 

This study suggests that planning ahead is the best strategy for retaining autonomy when living independently is no longer an option. 

 

Source:

 

Morgan, L.A., & Brazda, M.A. (2013).  Transferring control to others: Process and meaning for older adults in assisted living.  Journal of Applied Gerontology, 32(6).  651-668.