"You Lose Some Good Friends": Death and Grief in Assisted Living

Area of Science:

• Gerontology
• Psychology
• Sociology

Background:

• Assisted living (AL) facilities provide residential care for older adults, often involving end-of-life experiences.
• Understanding the psychosocial impact of death on surviving residents is crucial for quality of care.
• Existing research may not fully capture the multi-level responses to death within AL settings.

Purpose of the Study:

• To investigate responses to death at multiple levels within the assisted living (AL) system.
• To characterize the psychosocial impact of death on surviving residents in AL communities.
• To identify potential interventions for improving end-of-life care and grief management in AL.

Main Methods:

• Secondary thematic analysis of diverse data sources from a larger quantitative study.
• Inclusion of community documents (newsletters), observational field notes, and resident interview data (n=18).
• Analysis focused on administrative practices, staff communication, and resident psychosocial responses to death.

Main Results:

• Three key themes emerged: administrative memorialization, resident perceptions of staff communication, and resident psychosocial responses.
• Surviving residents employed adaptive and avoidant coping strategies for grief, extending to losses of deceased residents' social networks (family, friends, pets).
• Residents perceived memorialization and communication practices as inconsistent with the desired "family-like" social atmosphere.

Conclusions:

• A multi-level approach targeting administration, staff, and residents can enhance psychosocial end-of-life care and grief management in AL.
• Social workers are vital for psychosocial interventions but face systemic barriers (staffing) limiting their clinical roles in AL.
• Findings underscore the need for integrated strategies to support residents through bereavement within the AL environment.