Adult Foster Homes in an Aging America: Trends, Effects, and Operational Challenges (2017–2023)

dc.contributor.advisorChair, Paula Carder
dc.contributor.advisorTunalilar, Ozcan
dc.contributor.advisorMesser, Lynne
dc.contributor.advisorCarlson, Bryant
dc.contributor.authorAlbalawi, Wafi
dc.date.accessioned2025-03-27T02:09:10Z
dc.date.issued2024
dc.description.abstractBackground: As the aging U.S. population grows, the demand for long-term care services (LTCS) is rising. Adult Foster Homes (AFHs), small residential care settings providing personalized support for older adults, play a critical role in meeting this demand. However, limited research has focused on AFHs compared to other LTCS options. This dissertation examines Oregon’s AFH holistically by assessing home characteristics, resident’s status and health needs, and the experiences of operators, particularly during the COVID-19 pandemic. Methods: Utilizing data from the Oregon Community-Based Care study (2017–2023), this mixed methods research integrates quantitative trend analyses and qualitative content analysis. It explores three key aims: (1) identifying trends in residents' health conditions, service utilization, and medication use; (2) assessing associations between AFH characteristics and healthcare outcomes; and (3) capturing operators' perspectives on rewards and challenges during the pandemic. Results: Findings reveal high prevalence rates of dementia and polypharmacy among residents, with increasing medication use and stable trends in ADL needs. Family involvement significantly declined during the pandemic but showed partial recovery post-restrictions. Operators highlighted meaningful rewards, such as resident care and autonomy, alongside challenges like regulatory burdens and low Medicaid reimbursement rates. Conclusion: By highlighting the unique attributes, resident health needs, and operational challenges of AFHs in Oregon, this study brings critical attention to an often-overlooked long-term care option
dc.format.extent148
dc.identifier.urihttps://hdl.handle.net/20.500.14154/75077
dc.language.isoen_US
dc.publisherOregon Health and Science University
dc.subjectOlder Adult
dc.subjectAging
dc.subjectLong-Term Care
dc.subjectFrail Elderly
dc.subjectPublic Health
dc.subjectCommunity Health Services
dc.subjectPopulation Health
dc.subjectCOVID-19
dc.subjectHealth Status
dc.titleAdult Foster Homes in an Aging America: Trends, Effects, and Operational Challenges (2017–2023)
dc.typeThesis
sdl.degree.departmentOHSU-PSU School of Public Health
sdl.degree.disciplineCommunity Health - Social Epidemiology
sdl.degree.grantorOregon Health and Science University
sdl.degree.nameDoctor of Philosophy

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