Intergenerational influences on family decision-making for long-term care and senior services

Decision making regarding housing and services for seniors is a complicated process. Different generational perspectives influence the family decision process. The over 65 age group continues to grow at an unprecedented rate. Few care delivery systems accommodate this expanding population through home and community-based services that enhance quality of life. The purpose of this qualitative phenomenological study was to explore the lived experiences and generational-based perspectives of seniors and their families to examine current and future influences on senior care delivery systems. The phenomenological study used the van Kaam design modified by Moustakas for data analysis. The research involved interviews with 25 seniors from one of three independent living facilities in southeastern Michigan and a corresponding family member. Findings from the study included five themes expressed as: (a) being close to family as a key factor for moving to independent living, (b) participative decision-making for past decisions, (c) participative decision-making for future decisions, (d) preferences in the independent living environments, and (e) desired home and community-based services. The conclusions derived from the analysis suggest the importance of family on health, welfare, and social connections for seniors, greater dependence on family support as mental and physical health declines, and the importance of active, engaged environments for seniors whether in congregate care or home settings. Future services to seniors outside of congregate care appear to be an underdeveloped aspect of the long-term care continuum. Future quantitative research is recommended to test the strength of preferences across generational cohorts.