The Historical, Political, Social, and Individual Factors That Have Influenced the Development of Aging and Disability Resource Centers and Options Counseling

摘要

This thesis reports on the perspectives and experiences of policymakers, advocates, agency supervisors, and experts in the field of gerontology, about the development of Aging and Disability Resource Centers (ADRC) programs and Options Counseling (OC). By examining the foundations upon which ADRCs and OC are built, this study sought to inform future research about the effectiveness of existing practice, increase understanding of best practices, and clarify whether these emerging services are accomplishing original goals.ADRCs and OC intend to address long-term care issues and healthcare needs by providing a single entry point to the social service system. ADRCs offer information, assistance, and OC to people of all ages, incomes, and disabilities, and promote long-term care options that honor independence and respect for the needs and preferences of individuals, their families, and caregivers. They are the latest iteration of policymakersu27 efforts to provide affordable home-and community-based care for older persons and their caregivers.A total of fifteen qualitative interviews were conducted and analyzed using grounded theory methods. Key persons interviewed included experts in the area of aging, aging policy, and aging. Participants were recruited through referrals suggested by Portland State Universityu27s (PSU) Institute on Aging (IOA) staff. In addition, several key experts known to the researcher through affiliation with PSUu27s IOA agreed to be interviewed. Snowball sampling was then used to locate additional key experts.Interview participants were classified as advocates, state decision makers, policy makers, or academicians. Advocates included national and state directors of agencies that promote the development and management of effective services to aging adults. State decision makers included state directors, ADRC directors and supervisors, and program analysts. Policy makers interviewed were national program directors responsible for shaping the future of developing programs to assist older adults. Academicians who participated in the study have been instrumental in developing and researching practices that promote well-being for the aging and the aged. These key experts were selected based on their knowledge and ability to inform the strengths, weakness, and development of ADRCs and Options Counseling. Many have been instrumental in health and aging policy and service development and research, and possess insider knowledge not available to the general public regarding attitudes and interests motivating the actors.Findings indicate that ADRCs and OC are designed to manage within existing social service systems. They can benefit some individuals by providing more options and support in accessing public and private services. It remains to be seen whether they have the capacity to ameliorate some existing system-level problems. Findings highlight program strengths and weaknesses, sustainability issues, and policymakers, state decision makersu27, and providersu27 commitment to sustaining ADRCs and OC.