First Advisor

Paula Carder

Term of Graduation

Fall 2021

Date of Publication

12-16-2021

Document Type

Dissertation

Department

Community Health

Language

English

Physical Description

1 online resource (ix, 146 pages)

Abstract

Antipsychotic medication use (APU) in assisted living and residential care (AL/RC) settings is an under-studied and controversial health policy issue. APU in older adults with dementia is associated with an increased risk of falls, hospitalizations, and early mortality. I operationalize the Institutional Analysis and Development Framework using a situational analysis approach, an extension of grounded theory methods, to explore the APU in Oregon AL/RC settings. Regulatory deficiency citations, Oregon AL/RC population data, and semi-structured interviews suggest that staff role clarity, organizational characteristics, and perceived agency influence decision-making around APU. AL/RC providers and caregivers are forced to simultaneously balance and prioritize regulatory goals, organizational constraints, and complex care provision resulting in a multilayered, complicated, and unique situation. Findings highlight the need for creative policy and population health-minded solutions that reflect the practical reality of providing care in AL/RC settings to promote quality of life for residents.

Rights

In Copyright. URI: http://rightsstatements.org/vocab/InC/1.0/ This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s).

Persistent Identifier

https://archives.pdx.edu/ds/psu/36903

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