Dissertation Defense: Seth Dornisch

Directed by: Professor Lynnette Leidy Sievert

ABSTRACT:

Older adults in the United States often relocate to receive assistance as their functional abilities decline. An increasingly popular form of senior care provides housing and a continuum of care services within a designated community campus. These communities are spatially and socially divided into residential zones where care is provided at varying intensity levels. This dissertation project aimed to identify personal and environmental variables that support the well-being of residents in US continuum-care communities. Data were collected from residents of two communities in southern California, one non-religious and the other Jewish. Semi-structured interviews, standardized questionnaires, and ecological momentary assessment methods were used to document residential experiences and environmental conditions across different levels of care within these communities. Data were analyzed using qualitative and quantitative techniques to identify characteristics of people and places that supported residents’ well-being. Analyses were conducted to examine associations between (1) feeling at home and quality of life, (2) time-use and mood, and (3) religiosity and mental health. Results showed that a longer duration of residence, the presence of personal belongings, and privacy were associated with feeling at home in one’s living space, which in turn was associated with a better quality of life. Spending time outdoors, exercising, and being with loved ones were associated with better momentary mood. Intrinsic religiosity, defined as a personal and internalized commitment to one’s religious worldview, was associated with better mental health. Overall, experiences of well-being did not differ significantly between the two communities but did differ across the levels of care within them. People living in less intense care zones reported more positive residential experiences. These findings suggest that an environment that feels like home and provides access to nature, movement, and meaningful socialization can support the well-being of older adults with declining health.