집'으로서의 노인보호주택 사례연구

Case Study of Assisted Living Facility (ALF) as a 'Home'

The purpose of this study was to examine the features that make residents feel “at home” in ALFs in Southwest Virginia and to suggest further policy and design guidelines for better Quality of ALFs as a “home.” For this purpose, residents' needs, experiences, and opinions of the physical environment, the social environment, and the organizational environments such as policies and programs of ALFs were identified. As a multi-case study, five ALFs in Southwest Virginia were studied using constant comparative methos of data analysis. In addition to face-to-face interviews with 25 residents and five administrators of five ALFs, observations were conducted with personal journal. Overall, the five sites selected presented homelike features showing the philosophy of assisted living which combines housing and services. Each facility was designed to be a single-family house or multi-family dwelling in outside appearance. As a whole, residents felt isolation and loneliness and they did not have active interaction with other residents because of diverse background among the residents. However, all of them had close relationships with the staff. The staff's attitude and behavior seemed to influence greatly the residents' feeling “at home.” Despite the provision of diverse activities by the facilities, many residents did not participate in the programs. Most of the residents agreed that the rule and regulations were fair. In spite of high satisfaction with the facility, many people did not think of their current dwelling as a real ‘home.’ As the biggest difference between living in their own homes and living in the ALF, people pointed out a lack of independence, freedom, and autonomy. Residents of ALFs may have reordered their priorities in their current life situation so that safety, security, and care were more important to them than feeling “at home.” Among the three factors --physical, social, and organizational-- that affect the residents' perception of ALFs as a “home, ” many emphasized the importance of social factors such as relationships with the staff and residents, and social support from their family or friends.