Multilevel examination of facility characteristics, social integration, and health for older adults living in nursing homes

J Gerontol B Psychol Sci Soc Sci. 2015 Jan;70(1):111-22. doi: 10.1093/geronb/gbu112. Epub 2014 Sep 11.

Abstract

Objectives: Testing a model based on past research and theory, this study assessed relationships between facility characteristics (i.e., culture change efforts, social workers) and residents' social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes.

Methods: Data were collected at nursing homes using a planned missing data design with random sampling techniques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with nursing home staff.

Results: The best fitting multilevel structural equation model indicated that the culture change subscale for relationships significantly predicted differences in residents' social networks. Additionally, social networks had a positive indirect relationship with mental and functional health among residents primarily via social engagement. Social capital had a positive direct relationship with both health outcomes.

Discussion: To predict better social integration and mental and functional health outcomes for nursing homes residents, study findings support prioritizing that close relationships exist among staff, residents, and the community as well as increased resident social engagement and social trust.

Keywords: Culture change; Nursing homes; Social engagement; Social networks; Structural equation modeling..

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Family Relations
  • Female
  • Health Status*
  • Homes for the Aged / standards*
  • Homes for the Aged / statistics & numerical data
  • Humans
  • Interpersonal Relations*
  • Kansas
  • Male
  • Mental Health / statistics & numerical data*
  • Nursing Homes / standards*
  • Nursing Homes / statistics & numerical data
  • Professional-Patient Relations
  • Residence Characteristics / statistics & numerical data
  • Social Capital
  • Social Support*