Shared living in Florida

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Shared living in Florida alternative living arrangements for older people
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viii, 279 leaves : ; 28 cm.
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Hilker, Mary Anne, 1946-
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Older people -- Dwellings   ( lcsh )
Older people -- Dwellings -- Florida   ( lcsh )
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Thesis:
Thesis (Ph. D.)--University of Florida, 1983.
Bibliography:
Includes bibliographical references (leaves 270-278).
Statement of Responsibility:
by Mary Anne Hilker.
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Typescript.
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Vita.

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University of Florida
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oclc - 09810632
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SHARED LIVING IN FLORIDA:
ALTERNATIVE LIVING ARRANGEMENTS FOR OLDER PEOPLE









BY

MARY ANNE HILKER


A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL
OF THE UNIVERSITY OF FLORIDA IN
PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE DEGREE OF DOCTOR OF PHILOSOPHY

UNIVERSITY OF FLORIDA


1983



































Copyright 1983

By

Mary Anne Hilker

































This work is dedicated
to the memory of
Maggie Mae O'Keefe
(1888 1981)














ACKNOWLEDGEMENTS


This study would not have been possible without the

cooperation and candor of the Share-A-Home Board of

Directors, administration, staff and, especially, the

residents. I received more than I gave, and I am in their

debt.

Funding for this research was provided by the NRTA-AARP

Andrus Foundation. Their generosity is greatly appreciated.

To my committee chairman, Dr. Gerald Leslie, and my co-

chairman, Dr. Gordon Streib, my thanks for your confidence

in me and for your gentle urging when I came to some

difficult places.

Dr. Streib, Ruth Streib and Ed Folts helped me and

learned with me throughout our long investigation of

shared living for older people. It has been a pleasure.

To my colleagues at the Center for Governmental

Responsibility, my thanks for their support and friendship

throughout the writing of this dissertation; a special

thanks go to Cindy Cart for typing this manuscript.

Finally, thanks go to my husband Larry who encouraged me

during the long months I lived in the "field," and who was

always there when I came home.





TABLE OF CONTENTS


PAGE


ACKNOWLEDGEMENTS ..... ........ ..................... iv


ABSTRACT.............................. .............. vii

CHAPTER


ONE INTRODUCTION.................... ....... .... 1

TWO THEORETICAL PERSPECTIVES..................... 11
The Symbolic Interactionist Perspective... 12
Theories of Primary Groups............... 15
Primary Group Relationships in Old Age.... 19
Overview .................................. 25

THREE LITERATURE REVIEW............................ 27
Studies in Nursing Homes ................ 30
Research in Personal Care Homes and
Shared Homes............................ 35
Research in Congregate Housing............ 38
Studies in Independent Housing
for the Elderly ........................ 43
Summary............ ...................... 47

FOUR METHODOLOGY.. ................ ............ 49
The Research Settings.................... 52
The Population. .......................... 55
Sources of Data........................... 57
Data Collection and Analysis.............. 59
Data Quality Control..................... 61

FIVE THE SHARE-A-HOME MODEL: BACKGROUND
AND PARTICIPANTS ............................. 64
History and Ideals....................... 64
Procedures and Policies................... 69
The Provision of Services.............. 70
General Policies ...................... 72
Participants: The Residents.............. 75
Participants: The Household Staff........ 85
Overview ............. ............... ..... 87

SIX EVERYDAY LIFE IN SHARED HOMES................ 90
The Share-A-Home Technology............... 90
Becoming a Resident: Socialization
to Shared Living...................... 94
Daily Routines.......... ................. 106











Contacts with Family and Friends
Outside the Homes ...................... 111
Community Ties ................ .......... 114
Overview ............ ............... ...... 116

SEVEN SHARED LIVES: RESIDENT RELATIONSHIPS........ 120
Emotional Ties and Helping Roles.......... 122
Conflict Among Residents.................. 134
Coping With Changes ....................... 141
Overview ............. ..... ............ .... 146

EIGHT CONTROLLING THE ENVIRONMENT: RESIDENT/
STAFF RELATIONSHIPS.......................... 149
The Roles of Staff........................ 149
The Roles of Residents ................... 155
Decision Making ...... ................... 158
Power and Compliance...................... 161
Overview ............................... ... 169

NINE THREE HOMES: CONTRASTS IN THE QUALITIES
OF SOCIAL LIFE............................... 172
Convent Home.............. ................ 176
Lake Home. ............................... 182
Country Home.............................. 189
Overview........... .. ....... .......... 202

TEN CONCLUSIONS: THEORETICAL AND
PRACTICAL IMPLICATIONS...................... 206
The Nature of Social
Relationships in Shared Homes......... 208
The Shared Home as a Type of
Social Organization................... 216
Implications for Policy and Practice...... 227
Future Research Needs ................... 234

APPENDICES

A RESIDENT INTERVIEW GUIDE..................... 236

B STAFF INTERVIEW GUIDE........................ 267

C INTELLECTUAL FUNCTIONING RATING SCALE........ 269


BIBLIOGRAPHY ... ........... ........ ...... ..... ..... .. 270

BIOGRAPHICAL SKETCH.. .... ........................... 279
















Abstract of Dissertation to the Graduate Council
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy



SHARED LIVING IN FLORIDA:
ALTERNATIVE LIVING ARRANGEMENTS FOR OLDER PEOPLE

By

Mary Anne Hilker

April, 1983

Chairman: Gerald Leslie
Cochairman: Gordon F. Streib

Major Department: Sociology

The number of people in this country aged seventy-five

or older will increase substantially during the coming

decades. This fact has stimulated interest in the develop-

ment of alternative living arrangements which could accom-

modate frail older people who cannot live independently, but

who do not require nursing home care. One type of alter-

native, known as shared homes, involves a group of older

people sharing a house and paying a staff to perform

domestic tasks.

One year of fieldwork, including six months of par-

ticipant observation, was conducted in ten shared homes in

Central Florida. The goals of this research were to







describe the structures and interactional patterns of these

households and to discover the extent to which primary group

ties might develop within them.

A comparative analysis of these households suggests that

social relationships are characterized by considerable face-

to-face contact but little intimacy. They are necessarily

impermanent relationships because of high resident turnover.

Residents engage in considerable mutual assistance as well

as non-reciprocal help to less able household members; they

also adhere to a norm of conflict avoidance.

These households may be conceptualized as emerging types

of primary groups which are similar in structure and tasks

to both neighborhood and friendship groups. They may also

be conceptualized as amalgam groups having elements of both

primary groups and bureaucratic organizations. The first

conceptualization is most relevant to understanding social

life in these settings during periods of low resident turn-

over. The second is most relevant during times of high

resident turnover and/or when a significant proportion of

the residents are seriously impaired.


viii













CHAPTER ONE

INTRODUCTION



This dissertation describes how some older people create

lives for themselves in one type of special environment for

the elderly--shared living arrangements. The settings are

ten homes located within a single county in Florida in

which groups of older people, dependent because of frailty

or chronic health conditions, and paid staffs share

households. The goal of the sponsoring organization is the

creation of "families" of older people who cannot live

totally independently, but who do not need or want institu-

tional care.

In the chapters that follow, some of the results of one

year of fieldwork, including six months of participant

observation in these homes, will be presented. This field-

work was part of a larger two and one-half year team

research project which investigated alternative living

arrangements for the frail elderly with both evaluative/

practical as well as theoretical objectives in mind. The

evaluative/practical component has been reported elsewhere

(Streib and Hilker, 1980; Streib and Folts, 1981).

The goals of this dissertation are








(1) to provide a description of the structures and

interactional patterns of these "families" of old

people, and

(2) to provide a comparative analysis of the "families"

to contribute to the theoretical understanding of

social relationships, particularly primary group

formation, in age-segregated residential settings.

The call for "alternatives" to institutionalization for

frail older people has been widely promoted both in the

gerontological literature (Thompson, 1975; Neugarten and

Maddox, 1980) and in the public press. The increasing num-

ber of people in this country aged seventy-five or older,

that group most prone to impairment and chronic conditions,

is one factor which has stimulated interest in such alter-

natives. Presently, those aged sixty-five and older

comprise 10 percent of the total United States population;

about one-third of this number is aged seventy-five or

older. Depending on whether mortality rates remain the same

or decline, there will be from twelve to eighteen million

people aged seventy-five or older by the year 2000

(Neugarten and Maddox, 1980).

The task of caring for a frail older person has tradi-

tionally fallen to the family, and certainly the family

still provides most of the care needed by the older member.

However, there are reasons that family participation may








decline in the future. Families are smaller and more mobile

than formerly. More women, the usual care-givers of the

elderly, are in the paid labor force. While the myth that

families dump their old parents into nursing homes has

largely been dispelled, more and more older people and their

families may have no choice but to seek out alternatives to

more traditional living arrangements.

Certainly the professional and public interest in alter-

natives has also been due to the bad press received by

nursing homes. Moss and Halamandaris (1977), for example,

present a detailed, negative portrait of nursing home care

in this country. The rapidly increasing cost of nursing

home care has stimulated the search for less expensive, as

well as more humane, solutions to the problems of older

people who require help from others but who do not need a

medically oriented residential setting.

Finally, the more general de-institutionalization move-

ment which has affected the care of the mentally ill, the

mentally retarded and other disabled persons has spread to

the care of the elderly. The trend to avoid institutional

placement in favor of alternative community services and

residential facilities has as its goal the provision of the

least restrictive environment for those who require a

sheltered setting. Estimates from professionals involved in

studying the problems of nursing homes suggest that from








one-third to one-half of the patients in these homes do not

need the intensive levels of care provided there (Huttman,

1977).

One type of alternative involves the simple idea of

older people living together in ordinary homes in the com-

munity and pooling their resources in some manner.

Household tasks may be accomplished either by resident

cooperation, usually with part-time help, or by total

reliance on a paid staff. Such arrangements are generally

referred to as "shared homes" (Murray, 1979). Sponsors for

shared living projects have included churches, community

action groups, government agencies, hospitals and self-help

groups.

Many variations of the shared living theme currently

exist or are in the development stages. These efforts are

based on various assumptions about the wants and needs, the

resources, and the limitations of a particular segment of the

older population, the frail elderly. The result has been a

variety of models of shared living based on different philo-

sophies and each having a somewhat different style.

However, underlying these variations is a common belief:

frail older people can obtain a higher quality of life by

sharing households than they can by living alone or in an

institution.

This dissertation focuses on one particular variation of

the shared living idea, one of the oldest and most publi-

cized, known as Share-A-Home. These particular shared homes








have been variously referred to as "communes" and as

"families" or "quasi-families" of the elderly (Sussman,

1976; Kellogg and Joffe, 1977; Streib, 1978; Crandall, 1980;

Harris and Cole, 1980). Yet these references in the geron-

tological literature have been based on little systematic

data. Therefore, a major objective of this research is the

provision of a detailed description of these social groups.

In addition to describing these settings, this research

proposes to contribute to the understanding of the nature of

relationships in age-segregated environments. The nature of

the interpersonal relationships of older people has

interested social scientists for some time. Of particular

interest are the primary group ties, those ties charac-

terized by face-to-face contact and emotional involvement.

While family and kin remain the central source of primary

affiliations in old age, researchers have suggested that

peers can and do provide important interpersonal support.

Furthermore, age-segregated residential settings have been

suggested as optimum environments for such peer rela-

tionships. For this reason, considerable research has been

conducted on the interpersonal relationships in retirement

hotels and apartment complexes, in housing subdivisions for

older people and in institutional settings such as nursing

homes.

Past research in residential settings for older people

has shown that the kinds of social relationships which develop








may vary according to the physical, organizational, and

policy features of the settings as well as the social and

personal characteristics of the residents. Thus, social

life in a nursing home may be affected by the physical

layout of the rooms and hallways, by the kinds of rules

imposed on daily activities, and by the levels of physical

and mental impairment of the patients. The recent emphasis

on alternatives to institutional care reflects not only the

recognition of the diversity of older persons' needs, but

also of the complex relationship between the social/physical

environments and the residents' well being.

The concept of a continuum of living environments for

older people presumes that there are real differences be-

tween points on the continuum in terms of the conduct of day-

to-day living. Few would argue that the quality of life in

a nursing home is quite different from life in a sunbelt

retirement village. However, there is as yet very little

information on how older people conduct their lives in

shared living settings and, therefore, how they compare to

other settings on the theoretical continuum of living

arrangements. Many such arrangements currently exist, and

more are in the process of formation. Although there are

certainly attitudinal barriers to the idea of shared living

among both the elderly and the larger population (Streib and

Streib, 1975), the idea appears to be gaining in popularity,








and sponsorship for shared homes is arising in both the pri-

vate and public domains.

These emerging structures present interesting sociologi-

cal and social policy questions. The sociological task is

the discovery and exploration of the nature of these social

groups, while policy-makers must learn how to respond to

them. Are they quasi-families? Are they old age institu-

tions requiring close monitoring by social service agencies?

Are they voluntary adult communities? The kind of par-

ticipant observation research in these settings which is

presented here will help answer both kinds of questions.

This research may be considered a sociologically

informed ethnography. That is, it combines the methods and

goals of the traditional ethnographer with those more

recently articulated by sociologists who are concerned with

developing theory from qualitative data. Thus the

researcher became the ethnographer-in-residence among

several small and relatively isolated communities with the

goal of understanding the entire cultures of the groups.

Yet the results presented here are not in the form of a tra-

ditional ethnographic account in which the minute details of

every day are described. Rather, an attempt has been made to

make the masses of qualitative data which accrue in the

course of fieldwork of this nature relevant to theoretical

issues in the sociology of aging and in the broader area of

social gerontology.








Yet while this report focuses rather quickly on several

specific themes it hopefully provides a sufficiently

detailed picture of life in these settings. The advantage

of participant observation, the primary method of the eth-

nographer, is that the researcher emerges with a rich and

varied wealth of data which she uses to fashion a coherent

account. Some flavor of the richness and detail is main-

tained in this dissertation by including both excerpts from

the researcher's field notes and direct quotations from

interviews.

Although the purpose of this research was not to test

hypotheses derived from any specific theory, a number of

theoretical perspectives were utilized in conceptualizing

the research problem, in choosing the methodology, and in

analyzing the data. Choosing to do a participant obser-

vation study is based on the theoretical assumption that

understanding social life involves the process of uncovering

meanings. The theoretical perspective of symbolic interac-

tionism provided the general stance from which the research

was undertaken. Thus, understanding the social life of

people in shared homes requires an investigation of the

meanings the participants attach to their experiences,

actions and interactions as well as of the normative,

organizational and physical features of these settings.

Such a theoretical perspective requires actual observation

of interaction in the research setting.








Only general research questions guided the initial

fieldwork, permitting the general texture and shape of life

in these settings to become part of the researcher's own

experience. These general questions have concerned other

researchers in various types of social settings including

residential settings for older people and included the

following:

What are the structural and organizational features of
these settings? How are they perceived by the participants?

What kinds of social relationships exist inside these
settings? What patterns of interaction exist? What
meanings do participants attach to these relationships and
patterns?

To what extent do these "families" exhibit the charac-
teristics of primary groups?

Answers to such broad questions necessitated spending

several months gathering qualitative, holistic data. Later,

more specific questions were investigated using a structured

questionnaire in addition to the observational methods.

During this phase, the themes of intimacy and support,

conflict, change, and power were the focus of more special-

ized data gathering techniques.

In the second chapter of this dissertation the relevant

theoretical perspectives and issues are presented. In

Chapter Three the previous studies which are pertinent to

this research are reviewed. Chapter Four presents a

detailed summary of the methods and data collection instru-

ments which were employed. In Chapter Five, the history and








structure of the sponsoring organization, and the members of

the "families" are described. Chapters Six, Seven and Eight

consist of the development of several major themes which

emerged in the analyses of the qualitative materials

obtained during the fieldwork. In Chapter Nine the

qualities of social.life in three of the homes, the primary

research sites, are compared and reasons for the differences

among them are suggested. A discussion of the theoretical

and the policy and practical implications of this research

is presented in Chapter Ten.













CHAPTER TWO

THEORETICAL PERSPECTIVES



This dissertation is a report of an exploratory study

of a particular type of social setting--shared homes for

older people. The object of the research was not to systema-

tically test hypotheses derived from any theory, but it was

guided by several theoretical perspectives which were used

to formulate initial questions and to select appropriate

methods. The primary group as a type of social organization

(Cooley, 1902; Litwak and Szelenyi, 1969) provided the con-

ceptual focus of this research while the symbolic interac-

tionist perspective (Mead, 1934; Blumer, 1969) provided both

theoretical assumptions and concepts, and methodological

strategies.

This research was undertaken to discover the nature of

social life in these shared homes for older people. What

are the consequences for older people who leave their

familiar homes and undertake a new style of living? The

nature of these questions led to an interactionist approach

--the search for meanings and interpretations--and to the

method of participant observation.

The interactionist approach has had considerable impact

on the development of theories of the family (Burgess, 1926;








Stryker, 1959) and theories of aging (Rose, 1962; Rose and

Peterson, 1965). While it has been criticized by some as

ignoring the macrolevel factors which affect the elderly

(Estes, 1979:11), the interactionist approach has been par-

ticularly fruitful in addressing the social psychological

aspects of growing old. For old age is a time when one's

interactions with others may undergo profound changes; many

of the significant individuals and groups in one's life may

be lost. It is also, for some, a time of declines in

energy, in health, and in resources. Interest in how older

people interpret such changes, and how they construct their

social lives during this stage of life, particularly with

regard to primary relationships, has led to a number of

theoretical formulations; those which have relevance for the

present research will be summarized later in this chapter.


The Symbolic Interactionist Perspective

The roots of modern symbolic interactionism may be

traced through the works of psychologists William James and

James Mark Baldwin, and sociologists Gabriel Tarde, Charles

Horton Cooley, and George Herbert Mead. Mead is recognized

as having made the most significant contribution to modern

symbolic interactionist theory. His theoretical system is

concerned with how interaction among humans maintains and

changes the human mind or intelligence, the social self, and

society. The human mind is able to use significant symbols,








gestures which have a common meaning to those involved in an

interaction. This ability permits the individual to have

internal conversations with himself and to take the roles of

others toward his own behavior (Mead, 1934:47-48).

The ability of the mind to interpret gestures also serves

as the basis for the development of the self. The self is

the capacity of an individual to represent himself as an

object to himself (Mead, 1934:135-36). A child obtains a

self by taking the roles of others during play. Eventually,

the individual acquires the ability to assume the role of

the "generalized other," that is, the attitude of the whole

community. At this stage the individual has a fully devel-

oped self which has arisen out of the community or social

group; he has been socialized (Mead, 1934:153-54).

'Human society exists through minds and selves, and at

the same time minds and selves emerge through human interac-

tion (Mead, 1934:227). Taking the role of the other by

means of symbolic interpretation makes cooperation within a

human group possible. Self-criticism through viewing one's

self from the entire community's perspective insures social

control over individual behavior (Mead, 1934:254-55).

Mead's theory has been most fully developed into a

systematic statement of the symbolic interactionist position

by Herbert Blumer. For Blumer, "symbolic interaction"

refers to the process in which humans interpret the








actions of others rather than merely reacting to such actions

(Blumer, 1962:145). That is, humans attach meanings to

each other's actions and these meanings mediate interaction.

The source of meanings is not inherent in actions or

objects, nor is it in the purely psychological processes of

the actor. Instead, meaning arises in the process of people

interacting and defining actions and objects (Blumer,

1969:4).

Such a theoretical perspective requires that the process

of interpretation must be caught by the researcher who hopes

to understand human behavior. This process can be ascer-

tained neither by looking for antecedent conditions nor by

inferring it from the overt action produced by it (Blumer,

1962:151-52). Instead, the researcher must assume the role

of those whose behavior she wishes to explain; she must

discover the meanings of actions and objects and the deci-

sions made on the basis of those meanings. The results take

the form of descriptive accounts from the actors about the

objects in their social worlds and their actions in various

situations (Blumer, 1969:51).

For the symbolic interactionist, actual instances of

human interaction are the basic sources of data. Denzin

(1978:7-8) has described the elements of face-to-face

interaction, or encounters. Encounters involve at least two

people taking each other's point of view. Interactions occur








in social settings filled with social objects that are acted

on by the participants. A set of rules tacitly shapes

encounters which vary according to the relationship of the

individuals to one another. However, such rules are created

and maintained through the process of group life; the rules

do not create group life (Blumer, 1969:19). The analysis of

social life, then, must capture the meanings which emerge

over time in interaction. Words, nonverbal gestures, styles

of dress and manners of speech are all reflections of sym-

bolic meanings and may all be important in explaining

behavior (Denzin, 1978:9).


Theories of Primary Groups

Charles Horton Cooley, a contemporary of Mead's, had a

considerable influence on the latter's theoretical work.

Cooley's most valuable contribution was the concep-

tualization of the "primary group," through which the indi-

vidual acquires the ideals and norms of society. Such

groups are characterized by relative permanence and by

intimate face-to-face association and cooperation, the out-

come of which is a "we" feeling of sympathy and mutual

identification. While there may be differences and com-

petitions among the members, there remains an allegiance to

the group (Cooley, 1902:23-27).

The family, the juvenile play group and the neighborhood

group are universal types of primary groups. In addition,








The family, the juvenile play group and the neighborhood

group are universal types of primary groups. In addition,

the same qualities of intimacy and association may be found

in other social groupings such as clubs, work groups and

fraternal societies. These groups are based on

congeniality, and oftentimes a genuine intimacy arises

(Cooley, 1902:24-26).

More recently, a theory of primary groups has developed

which offers an explanation of the variety of such groups

which exist in modern society (Litwak and Figueira, 1968;

Litwak and Szelenyi, 1969). Using a structural-functional

approach, Litwak and his associates suggest that Cooley's

conceptions of the types and dimensions of primary groups are

less applicable in modern technological society. Increased

mobility results in neighborhoods that are impermanent, and

kin and friends who may only infrequently engage in face-to-

face association. Only the nuclear family has maintained all

the classical dimensions of the primary group, but because

it is so small and limited in resources it may be

unable to perform all of the traditional tasks involved in

child-rearing or care during illness or disability. The

extended kin network may have many more resources than the

nuclear family, but it too is often low on face-to-face con-

tacts (Litwak and Szelenyi, 1969:466-471).

Primary group structures have survived in modern society

because technology has provided means to overcome the








transportation allow kinship systems to retain their viabil-

ity. Neighborhood groups still maintain face-to-face con-

tact, but do not have the dimension of permanent membership

that characterizes neighborhoods of earlier times.

Nevertheless, neighborhoods survive because they have devel-

oped rapid means of group indoctrination. If movement in

and out of the neighborhood is expected, orderly, and

planned, then newcomers may be accepted rather quickly. In

addition, if there are group norms for welcoming newcomers,

and if there are individuals or groups who are especially

assigned to welcome them, indoctrination can be rapid.

Finally, the extent to which newcomers and established resi-

dents are alike also contributes to quick acceptance of the

former (Litwak and Szelenyi, 1969:466-468).

Thus, instead of giving way to more bureaucratic organi-

zations, the primary groups have retained many of the tasks

they performed in earlier times. However, because of dif-

ferences in structure, they are best suited to different

types of tasks. Neighborhoods, characterized by proximity,

face-to-face contact and short tenure, are particularly

suited to emergencies, while kin groups with their relative-

ly permanent structure do best when long-term commitments

are involved. Friendship groups, based on affection and

similarity in income, education, sex, age and life cycle

stage, are best suited to act as reference groups in








fluctuating matters of taste and fashion such as child-

rearing methods (Litwak and Szelenyi, 1969:470-471).

Even though groups do not exhibit all the charac-

teristics of the classical primary group, they are not then

necessarily secondary or bureaucratic groups. It is more

useful to identify them as intervening groups between the

end points of the continuum. While these primary group

types differ from Cooley's conception of the primary group,

they are much more similar to it structurally than to any

other type of group. The extended kin system, the neigh-

borhood and the friendship primary groups are able to

supplement the primary ties of the nuclear family because of

this structural similarity (Litwak and Szelenyi,

1969:469-472).

Paralleling the notion of a continuum of organizational

structures with the bureaucracy at one extreme and the pri-

mary group at the other is that of a continuum of organiza-

tional tasks. Compared to the bureaucratic organization with

its trained experts and concentrated resources as described

by Weber (Gerth and Mills, 1946:196-244), primary groups are

best at accomplishing "non-uniform" tasks. These are tasks

so simple that they do not require a trained expert, so

idiosyncratic that the expert is unable to bring his

knowledge to bear in time, or they entail so many unknowns

that expert training is not possible (Litwak and Figueira,

1968:473-475).








There are, however, some organizations which are diffi-

cult to place on a continuum because they have both uniform

and non-uniform tasks. Total institutions such as prisons,

for example, have predominantly uniform tasks, but because

they demand the total time of the inmates, they also include

primary group tasks within their boundaries. Therefore, the

structures of some organizations may be amalgam types--com-

binations of bureaucratic and primary groups (Litwak and

Figueira, 1968:479-480).

Streib (1978:417), on the basis of preliminary obser-

vations, suggests that Share-A-Home may represent a new

amalgam organization, one which blends in one location both

familial (non-uniform) and bureaucratic (uniform) functions.

How both kinds of tasks are accomplished in these shared

living situations and the resulting quality of life for the

residents are not known at present. Streib suggests that

knowledge in this area should be of value to family

theorists and practitioners as well as to policy makers

(Streib, 1978:417-418).


Primary Group Relationships in Old Age

Despite the many changes which have occurred in the

structure and tasks of the family, it remains the most

valued source of primary group relationships for the older

person. While modern industrial societies may give priority

in terms of resources and opportunities to younger, more








productive members, the old remain securely knitted into

the fabric of the family (Shanas et al., 1968:452-432).

While the maintenance of the health and income of older per-

sons is often shared by bureaucratic organizations, the

family is still the primary care-giver in times of illness,

they still visit, and they still exchange goods and services

(Shanas, 1979:170).

Lowenthal and Robinson (1976:433) suggest that the sub-

jective aspect of old people's relationships in families,

peer groups and in other social groups and networks has been

neglected in social research. Instead, researchers have

focused on behavioral aspects such as the amount of interac-

tion and on the identification of significant others in the

older person's life. Therefore, little is known about the

individual's subjective perceptions regarding his or her

involvement in various groups and networks. As the indivi-

dual ages and experiences changes in significant roles and

relationships, the question arises as to how he or she

interprets such changes and how involvements in social

networks reflect these interpretations.

Sussman (1976:226-231) contends that the meaning and

significance to older people of family and extended kin

relations depends on the extent to which such groups provide

intimate human interaction and empathetic reciprocal

response on the emotional level. Whether other structures








such as friendship groups can provide this intimacy and

empathy is yet to be tested. Sussman hypothesizes,

however, that the model of shared living under study here

may provide such a structure.

The possibility that friendship or peer groups can and

do play important roles in providing emotional support and

opportunities for socialization to the status of old age has

often been suggested (Rosow, 1967 and 1974; Blau, 1973).

Again, however, little is known about the subjective aspects

of friendship or peer group relationships. The quantitative

aspects such as number of friends and frequency of interac-

tion are well researched; the quality of the relationships

and even the meaning of "friendship" remain poorly understood

(Lowenthal and Robinson, 1976:439).

Rosow (1974:157) hypothesizes that peer groups may com-

pensate for the loss of family and work relationships in old

age. His primary theoretical interest is in the processes

whereby individuals become socialized, that is, how they

acquire the values, norms, attitudes and behaviors which are

appropriate in old age. His own research has led him to

suggest that peers become the major primary group through

which socialization occurs. He suggests further that age-

segregation, preferably in a residential setting, is a

necessary condition for the development of primary group

ties (Rosow, 1974:156).








Socialization is a lifelong process of social learning,

of taking new roles and responding to new situations.

However, socialization during old age is highly problematic

because, in this society, there are so few expectations spe-

cifically concerning how old people should act (Deutscher,

1962:506; Cavan, 1962:528-530; Rosow, 1974:10-11).

Socialization is possible only if three conditions are met.

The individual must have knowledge of what is expected of

him or her, the ability to use this knowledge to shape his

or her behavior, and the incentive to become socialized

(Brim and Wheeler, 1966:25). According to Rosow, few people

have incentives to accept growing old because old age is not

valued in our society. In theoretical terms, growing old is

a special case of socialization to a devalued status (Rosow,

1974:XIV).

Socialization to old age differs in other ways from

other transitional periods. There are few public obser-

vances of change, and those that do exist, such as retirement,

widowhood, or insitutionalization, usually occur well after

one has become defined as old by other people (Rosow,

1974:22-24). Unlike other stages of life, old age exhibits

systematic social losses rather than gains, and unlike the

situation in some other societies, the old do not acquire

additional responsibilities for which they are rewarded

(Cowgill and Holmes, 1972).








Thus, c

(Burgess, ]

attached tc

unclear. C

does exist

are suppose

institution

there should

Rosow's viE

behavior tl

not become

ways (Rosov

Rosow'E


Ld age is viewed by some as a "roleless role"

)50:138). There are few behavioral prescriptions

old age; the content of the role is vague and

ie of the few expectations of old people that

:enters on the issue of dependency. Old people

I to live independently for as long as possible,

ilization should be avoided at all costs, and

1 be some intergenerational reciprocity. In

I, society has so little stake in old people's

it they may do as they please, providing they do

)urdens on others or act in extremely bizarre

1974:57-66).

ideas about socialization through peer group


relationship )s are related to an earlier theory of the aged

subculture 'Rose, 1962). Rose hypothesizes that old people

react to be -ng devalued and excluded by society by forming

unique subc ltures of the aged. Subcultural formation

occurs bece ise older people, as they age, tend to interact

with each c :her more and more and with younger people less

and less. ?hus, older people construct new self-conceptions,

behaviors id attitudes out of their interaction with other

older people. Rose perceives a growing tendency for older

people to t link of themselves as part of an aging group and

to develop in aging group identification; they are being

transformed from a social category to a social group (Rose,

1962:126).








The subculture of aging conception has been criticized,

largely because there is no empirical evidence to suggest

that any societal-wide age-based political movement has

developed (Atchley, 1980:23). Rosow theorizes, however,

that when old people are insulated from other age groups,

especially in residential settings, strong subcultural

development may occur even though on a narrow and localized

scope. Thus, age segregation may compensate for the lack of

social roles available to older people in our society

(Rosow, 1974:156).

Rosow is not suggesting, however, that age alone is a

sufficient basis for the development of unique subcultures

of the old. While old age is a necessary condition for such

development, the group must be socially similar in other

ways (Rosow, 1974:156; Lowenthal and Robinson, 1976:440).

Homogeneity in backgrounds and interests further assures the

development of old-age-specific norms, roles and values;

hence, it is likely that a variety of old age subcultures

will arise rather than a societal-wide subculture of the

aged.


Overview

Symbolic interactionism provided the general perspective

from which this research was undertaken. Implicit in this

perspective is the methodological strategy of participant

observation. Through this method the researcher approaches








the individuals or groups under study with the objective of

obtaining their interpretations of events in their worlds.

From the interactionist perspective, the individual creates

his social world through his constant interpretation of the

meanings of situations; he is, in turn, shaped by that world

he creates.

The types and characteristics of primary groups, as

described by Cooley and later developed by Litwak and his

associates, are the major conceptual foci of this research.

The kinds of tasks accomplished by family, neighbors and

friends have changed in modern times and technological devel-

opments have caused an increased differentiation of primary

group structures. Today kinship ties are no longer main-

tained by high face-to-face contact but by improved methods

of communication and transportation. Neighborhoods are not

as permanent as they once were, but survive as primary group

structures because they still involve face-to-face contact

and have evolved rapid modes of indoctrination of newcomers.

Friendship groups survive without the bonds of permanence

that characterize kin groups and without the face-to-face

contact which neighbors have because they are based on

strong bonds of affection.

For older people the family remains the most important

primary group affiliation. Friendship and peer groups have

been suggested as possible substitutes for declining








involvement in other primary relationships in old age. In

age-segregated residential settings old people may

experience intimate association and cooperation and may

become socialized to the status of old age. The major

theoretical issues revolve around the conditions under which

primary groups develop in various types of age-segregated

settings in which older people become involved.

It has been hypothesized that new kinds of social groups

may be developing in which older people may find oppor-

tunities for intimate association and through which

socialization to old age may occur. How these amalgam types

of groups, having characteristics of both primary groups and

bureaucratic organizations, accomplish both familial and

bureaucratic tasks is not well understood at present.













CHAPTER THREE

LITERATURE REVIEW



Research on the primary relationships of older people

has traditionally focused on family and kin, the most valued

sources of such relationships. Friends, neighbors and other

non-kin as sources of primary group affiliation have recently

received considerable research attention, particularly in

residential settings consisting entirely or primarily of

older people. Research on social life in special residen-

tial settings for older people has typically involved either

observational accounts of particular settings or survey

studies of a number of such settings (Lemke and Moos, 1980:96).

The first are designed to capture the richness and

complexity of the settings, while the second seek to compare

settings on those characteristics which are quantifiable.

The previous studies which are reviewed here are, for the

most part, observational accounts; these accounts vary con-

siderably in regard to the scope and depth of the obser-

vations on which they are based.

All of the research reported here reflects the

researchers' interest in observing and explaining social

interaction in old age settings. While this general








research problem has frequently been conceptualized in terms

of the adaptation, adjustment and/or satisfaction of the

individual, more recent research has focused on a search for

evidence of intimacy or other indications of primary group

ties. In other studies the focus has been on "community"

formation. That is, to what extent do people who live in a

special residential setting interact and depend on each other

in important ways and to what extent do they identify them-

selves as part of such a community? Some of the research

reported here has been an explicit search for evidence of

the development of an aged subculture and/or the processes

by which people become socialized to the status of old age.

The living arrangements of older people are concep-

tualized by Atchley (1980:320) as a continuum based on the

degree of independence which the resident experiences in

her particular situation. (See Table One.) The criteria

which are used to place settings along this continuum are

related to task accomplishment: Does the resident perform

the task alone, with help, or is it done for her? Previous

research in both group housing, including nursing homes, and

independent housing is reviewed here.










TABLE ONE

Levels of Housing by Degree of Independence


Housing Type


Independent:
Fully independent





Semi-independent








Group Housing
Congregate housing







Personal care home








Nursing home


Significant Criteria


Self-contained, self-
sufficient household;
residents do 90 percent
or more of the cooking
and household chores.

Self-contained but not
entirely self-sufficient;
may require some
assistance with cooking
and household chores.
Example: independent
households augmented by
Meals-on-Wheels.


Can still be self-
contained, but is less
self-sufficient; cook-
ing and household tasks
are often incorporated
into the housing unit.
Example: retirement hotels.

Neither self-contained nor
self-sufficient; help
given in getting about,
personal care, grooming
and so forth, in addi-
tion to cooking and
household tasks. Example:
retirement homes.

Neither self-contained nor
self-sufficient; total
care, including health,
personal, and household
functions.


Source: Adapted from Atchley, 1980.









Studies in Nursing Homes

The sociological and anthropological accounts of old age

institutions including nursing homes and rest homes have

generally portrayed the interaction among residents in very

negative terms. Townsend (1962) conducted a now classic

study of a large number and variety of old age residential

facilities in England, including both charitable and

proprietary rest homes and nursing homes. He found some

variation among the facilities but, in general, he concluded

that close relationships among residents are both rare and

tenuous. Since there are few ties and little reciprocity of

services among residents, it is meaningless to speak of

"community" formation in these settings (Townsend, 1962:

336-37). Rather than residents helping each other and

liking each other, Townsend (1962:347-48) found a per-

vasive atmosphere of suspicion and hostility. Other early

studies have generally confirmed this picture of social life

in old age institutions (Henry, 1965; Henry, 1966).

More recently, Tobin and Lieberman (1976:196) docu-

mented extreme hostility among residents in a large nursing

home. These hostile perceptions and behaviors seemed to

increase from the time the resident entered the home. Most

researchers of institutional settings have observed very

minimal interaction among residents (Henry, 1965:474;

Jones, 1972:332; Snyder, 1973:320; Nygard, 1976:86;








Henderson, 1979:34). However, Tobin and Lieberman (1976:

196) found high levels of interaction albeit hostile and

aggressive in nature. They believe these findings are due

to the staff's constant promotion and rewarding of interac-

tion. These researchers concluded that encouraging interac-

tion by increasing opportunities and rewards will almost

surely result in highly conflictive situations. However the

alternative, in which interaction is discouraged, results in

withdrawal and alienation (Tobin and Lieberman, 1976:236).

There is evidence that nursing home patients often deny

the existence of conflict (Henderson, 1979:86) or avoid

situations of open conflict (Tobin and Lieberman, 1976:

165). An experimental study conducted by Jones (1972)

showed that introducing a program of recreational therapy

into a nursing home stimulated considerable conflict and

hostility among the patients. Jones concluded that there are

no apparent positive effects of introducing such a program.

The kinds of social life which develop in old age insti-

tutions have been attributed to a variety of factors. One

set of factors involves the personal characteristics of the

residents such as their physical and mental health (Gubrium,

1975:108), sensory capacities (Henderson, 1979:34) and

their personal idiosyncracies (Tobin and Lieberman, 1976:

237). Old people who are ill, or suffer losses in vision,

hearing or mobility might have difficulty relating to others

in the nursing home.








Gubrium (1975:91) and Miller and Beer (1977:274) con-

ducted research in large nursing homes and concluded that

outside relationships are much more important to residents

than internal ties. Patients simply preferred to maintain

ties external to the home; any ties which developed inside

the home were considered to be less important than outside

ties.

The heterogeneity of the resident population may have

important effects on the development of social rela-

tionships. Gubrium (1975:108), for example, observed

clique formation among nursing home patients which was based on

whether one was mentally alert or not. One's membership sta-

tus in such cliques largely determined where one sat in

public areas of the home and with whom one might sit during

meals and otherwise associate. Competent patients simply

did not want to be around "senile" patients.

A second set of factors used to explain behavior inside

nursing homes is related to the nature of all institutions.

For example, the kind of avoidance behavior which occurs

because residents fear contamination from other residents

(Goffman, 1962:146) has frequently been observed in old

age institutions (Jones, 1972:233; Fontana, 1977:157;

Gubrium, 1975:111; Tobin and Lieberman, 1976:166).

Thus, becoming a resident in a nursing home is seen as one

example of becoming an inmate in any institution, with all








its regimentation, depersonalization and coerciveness

(Henry, 1966:291-97).

Similarly, organizational constraints on resident social

relationships have been cited in numerous studies of old age

institutions. The specific policies and procedures which

result from organizational philosophies and goals necessarily

affect the social life of the institution. Thus, a highly

individualistic conception of nursing home patients may lead

to policies which ignore the ties which do, or could, exist

among them (Gubrium, 1975:121; Nygard, 1976:86). Some

administrative philosophies result in an aggressive style of

interaction among residents, while others foster a more

passive tone (Tobin and Lieberman, 1976:229). For

example, policies based on the theory of disengagement

(Cumming and Henry, 1961) may ensure that residents become

lethargic or disinterested (Bennett and Eisdorfer, 1975:

403).

In addition to organizational philosophies and policies,

the financial situation of the organization is thought to

play a major role in shaping social life inside the nursing

home (Bennett and Eisdorfer, 1975:403). Financial

constraints may place restrictions on the number and quality

of staff who may be employed as well as on the kinds of

activities and therapies available to the patients.

Staff who actually implement organizational policies

have been found to play central roles in residents' day-to-day








lives, particularly for less competent residents (Lowenthal

and Robinson, 1976:449). Staff-resident relations have

frequently been found to resemble that of parent and child

which is brought about by the high degree of resident depend-

ence on staff (Henry, 1965:440; Gubrium, 1974:66;

Henderson, 1979:48). Posner (1974:363) found that

nursing home staff unwittingly discouraged competent behavior

by giving most of their attention to the less competent

patient. Lowenthal and Robinson (1976:449) suggest that

the development of mutual aid among residents is hindered in

part because of the control exerted over them by a network

of staff who are professionally trained to be helpers.

Finally, certain physical features of the setting are

thought to particularly influence the quality of social

relationships among institutionalized older people (Lawton,

1970). Townsend (1962:169) observed that the residents in

institutions which provided individual bedrooms for resi-

dents seemed to interact more positively than did those

where less privacy was available. The size of the facility

has often been shown to be negatively related to the devel-

opment of resident social relationships (Curry and Ratliff,

1973:295). Henderson (1979:34) attributes a lack of

resident interaction to poorly planned seating arrangements

and high noise levels which inhibit communication among the

patients who frequently have visual and hearing losses.








Research in Personal Care Homes and Shared Homes

Observational studies in facilities which are variously

known as personal care homes, retirement homes, board-and-

care homes, group homes and shared homes are much less fre-

quently reported than is research in nursing homes. While

the latter are, in theory, designed and licensed to provide

trained nursing care and supervision, the personal care type

of home has no trained nursing staff, provides mainly

domestic services and may provide help with daily activities

such as bathing and dressing. While nursing homes are sup-

posedly for sick old people, personal care types of homes

are supposedly for well, but frail, old people. The shared

living homes reported on in this dissertation may be

appropriately placed in this category of group living.

Glasscote (1976) conducted a national field study of

board-and-care homes as well as nursing homes. Although his

goal was to judge the adaptation of ex-psychiatric patients

in such facilities, his observations and vignettes do provide

unusual, if brief, glimpses into social life in these homes.

Glasscote describes some board-and-care facilities in which

the residents sat staring at television sets all day,

interacting very little, a typical "back-ward" environment,

and other facilities in which the lives of the residents

appeared to be active and full (Glasscote, 1976:118-136).

Glasscote does not explain the differences in terms of








sociological variables but rather in terms of the emotional

resources of the residents and the enthusiasm and commitment

of the homes' operators.

Weber and Blenkner(1975) summarize the results of

several survey studies of boarding homes conducted by indi-

vidual states. The general impression of boarding homes

given by this research is that of depressing and isolated

environments in which the residents are expected to be

docile and unquestioning recipients of care (Weber and

Blenkner, 1975:287). The authors suggest that boarding

homes may be very poor alternatives to nursing homes for

those elderly who actually need professional care.

A rare report of group home living reveals little inti-

macy among the residents of several large apartments shared

by eight older people (Van Dyk and Breslow, 1978). By means

of interviews and observations the researchers discovered

that residents often expressed more positive feelings toward

the part-time homemaker employed by the sponsoring social

service agency than they did toward each other. Residents

appeared to be embroiled in constant interpersonal

conflicts, and without the intervention of a social worker

who visited weekly, the researchers doubted the group homes

could survive (Van Dyk and Breslow, 1978:52).

Murray (1979) reviews the few published reports and some

unpublished materials on the type of housing she designates








as shared homes. She differentiates shared homes from other

types of group living in that the former have as major goals

the provision of "supportive, family type" housing in a

"sharing environment" (Murray, 1979:3). The prevention

of institutionalization and the encouragement of indepen-

dence are also frequently stated by the sponsors as goals of

the shared homes. Murray concludes from the scanty infor-

mation on shared homes that serious problems can arise due

to the diversities of lifestyles and health conditions of

the residents, and unwillingness to share bathrooms and

other facilities, and the generally close quarters of shared

living (Murray, 1979:14-15).

Numerous articles on the Florida Share-A-Homes have

appeared in newspapers and popular magazines. However, only

one article in this model of shared living appeared in the

professional literature prior to the research on which this

dissertation is based. Based on preliminary observations,

Streib (1978) suggests that these homes may represent alter-

native family arrangements for older people. At least in

theory, such shared homes could provide the settings for the

development of primary group ties and could fulfill many of

the social psychological needs of the older person (Streib,

1978:417).








Research in Congregate Housing

A number of observational studies have been conducted in

a variety of types of residential settings which may be

broadly categorized as congregate housing. Congregate

housing, as the term is used here, includes residential

hotels and retirement apartment complexes. Such housing,

while clearly non-institutional, usually does involve some

meals and housekeeping services which are included in the

rental fee.

Residential hotels have recently received some research

attention. Such hotels are typically found in urban areas

and serve as permanent residences for a predominantly

elderly clientele. Stephens (1975;1976) found one such

hotel to be occupied by isolated old people who value pri-

vacy and independence above all else. Friendship and inti-

macy were rare, and any mutual assistance was a purely

instrumental exchange. Stephens employed an interactionist

perspective to uncover the network of relationships and

roles which developed in the hotel. She concluded that the

residents of this particular urban residential hotel were

typically life-long isolates who chose to live in such set-

tings so they might continue to avoid intimate contact with

others (Stephens, 1975:253).

Teski (1979), in an anthropological study of another

run-down urban retirement hotel, focused on the unequal








power relations between hotel staff and the tenants.

Although these hotels are not usually considered to be

institutions, Teski's descriptions of staff-resident rela-

tionships is quite similar to those found in nursing homes

and other institutional settings. Residents share a common

feeling that staff had most of the power and, in order to

share in this power, staff favor must be obtained (Teski,

1979:13).

Residents expressed considerable resentment toward the

less competent among them because they created a nursing home

atmosphere (Teski, 1979:72). As has been found in nursing

homes, the fear of being infected or contaminated by asso-

ciation with "senile" old people created a tremendous ten-

sion within the setting and, in the author's opinion, made

the formation of a real community.extremely difficult

(Teski, 1979:74). She concludes, however, that in spite

of the many difficulties, such a community of older people

does exist in this hotel, based on shared values, symbols

and most importantly, shared problems (Teski, 1979:152).

A small apartment complex for old people administered by

a public housing authority was the setting for an extended

field study by Hochschild (1973). The tenants were low-

income widows who were part of a distinctive subculture or

community. Hochschild argues that the basis for this sub-

cultural development is the sibling bond, a kind of








relationship based on reciprocity and on similarity in needs

and social characteristics. Residents were engaged in

extensive networks of exchange which bind people together.

Unlike institutionalized old people, the residents in

this facility were not merely the recipients of service but

were also givers; the parent-child relationship, so charac-

teristic among staff and residents in institutions, was not

found here. Whatever sibling solidarity might arise among

institutionalized old people is overwhelmed by this stronger

parent-child bond between staff and residents (Hochschild,

1973:63-68). This study suggests that viable community

development is possible in a small facility among "younger"

old people who have much in common. Hochschild (1973:140)

questions whether similar findings would emerge in larger

residential facilities, among those who have less in common,

or among the very old.

Jacobs (1975) also studied a public housing authority

apartment complex for older people. Unlike Hochschild,

Jacobs found little interaction among residents, and no sense

of community was evident. Jacobs explains the differences

between his findings and those of Hochschild's by the fact

that the residents were healthier, the building smaller, and

the layout more conducive to interaction in the complex

Hochschild studied. He also suggests that Hochschild her-

self helped to create the community she observed when she








began acting as the social director for the building

(Jacobs, 1975:102-105). His own research suggests that

enthusiastic staff may be necessary in such settings to com-

bat the apathy and lack of participation of the residents

(Jacobs, 1975:46).

Seguin (1973) attempted to demonstrate that a life care

retirement complex can provide the social structure in which

old people can establish positions, roles and norms through

which socialization to old age may occur. An elaborate

voluntary association of residents provided opportunities

for the development of work and family-like roles. Those

residents who became in need of the extensive health care

available on site were socialized into a "deviant adult

status." Other residents encouraged these residents to

withdraw from participation and regarded them as dependents

for whom services should be provided by staff and resident

helpers.

Ross (1974;1977) investigated a high rise apartment

complex for retired construction workers in France. Ross,

like Hochschild, explicitly conceptualized her study as a

search for evidence that old age may serve as a basis for

community. She suggests that territoriality, a "we-feeling"

and a system of social organization are characteristics of a

community (Ross, 1977:151-54). That is, a community exists

among people who share a common space, who have a subjective








sense of sharing a common existence, and who take part in

regular patterns of social living with norms, roles and

beliefs which have developed in that particular setting.

The old people in the facility Ross studied formed a

community because they were similar in backgrounds and

because they realized they shared the common fate of being

there for the rest of their lives. The complex was small

enough for face-to-face contact and the development of pri-

mary group ties was facilitated by small tables in the com-

munal dining room. Interdependence among residents was

extensive as were the social and emotional ties of

friendship. The sense of threat from the outside world and

from staff, and the fear of being alone and powerless,

helped to promote community formation. Ross found that pre-

vious status and roles were less important to the residents

than the new ones which developed inside. Resident par-

ticipation in decision-making was extensive and was facili-

tated by the existence of residents with strong leadership

abilities (Ross, 1977:156-71).

Ross found that residents became socialized within the

community by means of political factions within the resi-

dence. Through identification with and participation in

these factions, residents both learned and defined the rules

and meanings of community life. A considerable portion of

social life was spent in factional disputes which served to








focus the residents' attention inside the community, thus

strengthening external boundaries (Ross, 1977:125-26).


Studies in Independent Housing for the Elderly

Although the distinction between independent and

congregate types of housing is not always clear, indepen-

dent housing especially for older people generally includes

mobile home parks and retirement subdivisions or "villages."

In this kind of housing residents maintain separate resi-

dences, which they often own, in which they perform all or most

of the duties of cooking and housekeeping. Communal

recreational areas are common as are planned group activi-

ties in these settings.

Two observational studies of mobile home parks con-

sisting of mostly retired people provide contrasting pic-

tures of social life. Johnson's (1971) investigation of a

mobile home park revealed the existence of strong in-group

feelings and an elaborate social structure established and

maintained by the residents. Because of these factors and

also because the park was physically separated from the rest

of the surrounding residences, Johnson argues that a true

community exists in this setting of socially similar older

people. She goes further by suggesting that other mobile

home parks in the same metropolitan area form a kind of

supra-community in which the same kinds of people and social

patterns may be found (Johnson, 1971:60-61).








An anthropological study by Angrosino (1976) resulted in

quite a different understanding of the urban mobile home

park. Like the retirees in Stephens' study, the residents

of this park were very similar in terms of age and economic

circumstances but these similarities failed to produce a

sense of we-feeling among the residents. Interviews with

the residents did reveal their feelings of powerlessness

in the face of a park staff who made most of the decisions

about the operation of the setting. A community did not

exist at all, only a number of people subject to the

authority of a bureaucratic structure. Angrosino suggests

that the park is analogous in its social dynamics to an

Indian reservation where an outside bureaucracy imposes its

structure on the residents (Angrosino, 1976:174-80).

Some field studies have taken place in so-called retire-

ment villages or communities. Such planned residential

areas usually consist primarily of single-family dwellings;

recreational, shopping, laundry and other services are often

located within or adjacent to the retirement community.

Jacobs (1974:31), in an ethnography of a retirement

village, found that most residents did not participate in

the many activities and clubs available there. In fact,

most of the residents appeared to stay home and watch tele-

vision. Poor health, lack of public transportation, and

individual temperament are believed to be contributors to








this. However, he also suggests that the social isolation

of many of the residents is the result of the structural

inflexibility of all age-segregated communities. Diversity

is not encouraged; in this particular community only white

middle-class people were found. The consequence is an

unnatural, low-stress, unchallenging environment which leads

to isolation and apathy (Jacobs, 1974:81-82).

Jacobs (1974:73) identifies the predominant norm

within the retirement community as that of conflict

avoidance; all of the residents appeared to conform to a

"keep the peace" expectation. Becoming socialized within

the community involves learning that one must do everything

possible to give offense to no one. Jacobs suggests that

the process of "situational adjustment" (Becker, 1964:44),

a key feature in the process of adult socialization, is

clearly demonstrated by the nearly universal compliance

with the norm of conflict avoidance.

Jacobs also offers his data as evidence that old people

in retirement communities do develop a group identification

as Rose's subculture theory suggests. However, unlike Rose,

Jacobs believes such a group identification will have more

negative than positive effects on the elderly because it is

achieved through resentment toward the younger generations

and through segregating the old from the young (Jacobs,

1974:75-76).








Another field study of a residential retirement village

was conducted by Byrne (1974). Unlike Jacobs, Byrne

observed extensive participation in the activities and clubs

available in the retirement village; she detected a "cult of

activity" which predominated in this setting. Neighbors were

involved in considerable mutual aid such as doing errands

and helping each other during illness. However, the neigh-

borhood did not function as a big extended family where

everyone took care of everyone else. The helping networks

consisted of only a few people, all of whom could recipro-

cate in some way. Neighbors did not give much help to those

who were disabled and made excessive demands; they felt it

was the village management's problem to cope with such

people (Byrne, 1974:140-141).

However, while residents seem to interact more in Byrne's

than in Jacobs' research setting, a similar norm of conflict

avoidance was in evidence. Residents rarely confronted each

other but rather referred any problems or tensions to the

village's administration or management. Byrne detected

little attempt on the part of residents to control deviant

behavior by any means, overt or discreet, other than by

reporting to the higher authority. This applied to viola-

tions of formal regulations as well as to conflicts in habits

or lifestyles (Byrne, 1974:142).









Summary
Previous observational studies have taken place in all

types of old age residential settings. The development of

primary groups ties and/or a sense of community among resi-

dents is the most problematic in settings such as nursing

homes. In such settings, the residents are either too men-

tally or physically infirm or too hampered by the structure

of institutional life to develop meaningful relationships

with each other. While research shows that the nature of

social life varies somewhat from institution to institution,

the overall conclusion which must be drawn from earlier

studies is that institutional living offers a poor quality

of life for older people.

Little research has been conducted in the types of group

housing known as personal care homes, retirement homes and

shared homes. These are typically small group living

arrangements which vary widely in terms of the kinds of

older people in residence and in terms of staffing and ser-

vices. The type of small group residences known as shared

homes is characterized by an emphasis on the creation of a

"family" environment.

Much of the research which has occurred in congregate

living arrangements such as apartment complexes has resulted

in portrayals of elaborate community development in which

residents develop complex systems of social interaction,








mutual dependence and meaningful, subjective senses of com-

munity. In these settings, the residents tended to share

many social characteristics and were healthy enough to par-

ticipate in networks of reciprocal exchange. There is evi-

dence that true communities may develop in age-segregated

apartment complexes, hotels and other types of congregate

living arrangements.

The research conducted in independent housing for older

people such as retirement housing subdivisions and mobile

home parks has resulted in conflicting portrayals of social

life. Some researchers found considerable resident interac-

tion and a positive sense of identity with an aged community.

Other research suggests that the very homogeneity which

helps to foster community development in congregate settings

results in an environment which provides little challenge or

stimulation to develop or to participate in community life.

Still other evidence suggests that the imposition of a

bureaucratic structure in these so-called independent

housing arrangements acts to prevent community development

by putting decision-making in the hands of a paid staff.













CHAPTER FOUR

METHODOLOGY



The methods used in this study reflect the theoretical

assumptions used to organize and structure the research.

The interactionist framework necessarily produces a par-

ticular view of the research act (Denzin, 1978:6).

Understanding the meanings of events for participants in

these settings is best achieved by developing an "intimate

familiarity" with the people, the settings, and the

situations (Whyte, 1955:357).

The method of participant observation is well suited to

the task of achieving this "intimate familiarity." Schwartz

and Schwartz (1969:91) define participant observation

as a process in which the
observer's presence in a social situation
is maintained for the purpose of scien-
tific investigation. The observer is in
a face-to-face relationship with the
observed, and by participating with them
in their natural life setting, he gathers
data.

Participant observation, as conducted by sociologists,

typically involves several specific methodological tech-

niques. It is, then, less a single method than it is a kind

of research style combining several methods toward the goal








of scientific understanding (McCall and Simmons, 1969:3).

In addition to participating in the on-going life of the

group the participant observer may conduct formal and infor-

mal interviews, and gather and analyze documents or other

materials which are directly or indirectly related to the

group. Such a strategy of methodological triangulation

(Denzin, 1970:471) allows the researcher considerable flexi-

bility in choosing the most appropriate technique for any

given problem and also serves as a basis for checking

validity.

The goal of participant observation is the production of

an explanatory account of the social organization under

investigation which is grounded in the direct and repeated

observation of that organization (Glaser and Strauss, 1967;

Denzin, 1978). Ordinarily participant observation is not

used to test hypotheses derived from established theory.

Rather it is used either to apply and modify such theory

(McCall and Simmons, 1969:3) or to generate new theory

(Glaser and Strauss, 1967:18).

A researcher may assume one of several roles while con-

ducting the fieldwork (Gold, 1969:30). Regardless of the

level of participation the researcher chooses, she must take

into account the ways in which she affects the data being

gathered. The research reported in this dissertation was

undertaken by assuming the "participant-as-observer" role.








The role of "participant-as-observer" involves openness

about the researcher's identity and purpose and involves a

high level of participation within the group (Gold,

1969:35). The researcher is in a position to both affect,

and be affected by, the situation she is investigating

(Schwartz and Schwartz, 1969:94).

Understanding shared living arrangements for older

people requires a basically qualitative research strategy.

Like much of the social world of older people, little is

known about the organization and the quality of life in

these settings (Keith, 1980:8). The kind of research that

needs to be done entails studying older people in a variety

of ongoing social settings (Atchley, 1980:18-19).

Of particular interest in the field of aging has been

the issue of change in residential settings for the elderly.

The type of extended fieldwork reported here enables docu-

mentation of the sequence of events leading to change over

time in these settings. The detection of some kind of

change as well as subtle social relationships may be

possible only through extended periods of patient obser-

vation in old age living arrangements which are typically

characterized by low activity levels.

In addition to the essentially unknown character of

shared homes and the interest in documenting changes in such

groups, there is a third factor which makes the methods








chosen here quite appropriate. Frail, elderly persons have

trouble reading questionnaires and answering forced choice

questions (Bechtel, 1974:28). Thus while many of the resi-

dents in these shared homes were able to take part in an

extended formal interview, many were unable to do so. The

triangulation strategy employed here insured that the latter

were not excluded from this study.

Keith (1980:17) suggests that self-reports by older

respondents may be less than adequate. Problems with

memory, fearfulness, distractibility and idealization

towards norms make the use of observational methods highly

desirable in certain settings of older people.


The Research Settings

The research settings are ten Share-A-Homes which are

located in Orange County, Florida. Nine of these homes are

located in the Orlando and adjacent Winter Park areas and

are within a five mile radius. In three instances, two

homes are located within two blocks of each other. The

tenth home is located in a small town about twenty miles

west of Orlando.

The ten homes vary in size, in the types of neigh-

borhoods surrounding them, and in architectural design. Five

of the homes are attractive, one-story dwellings built as

single family residences. Each home can accommodate about

eight residents and one or two live-in staff. All of these








small homes are located in predominantly residential areas

and do not appear any different from any of the other

"ordinary" houses in the neighborhoods.

The five larger homes can accommodate from fourteen to

twenty residents and two or more live-in staff. Two of

these are large older homes and are leased from an adjacent

private college. The three remaining larger homes served

as the primary research sites as the researcher rotated her

residence among these three. These three were chosen as the

researcher's residences more for practical than theoretical

reasons. These homes were the only ones with vacant single

rooms available during the research. Also, trying to reside

in one of the small homes would probably have been much more

disruptive for the residents and staff than it proved to be

in the large homes. A brief description of these three pri-

mary research sites is given below:

(1) Convent Home is a large, old two-story stucco

building formerly a Catholic convent, located a few blocks

from downtown Orlando. Most of the bedrooms are tiny and

house only one person. Each bedroom has a sink, but toilet

and bathing facilities are centrally located on each floor.

Up to 18 residents, a manager/couple and a housekeeper may

live here. This structure is leased from the Catholic

diocese.

(2) Lake Home is a huge, two-story mansion built about

fifty years ago on the shores of a large lake. The grounds








are spacious and beautiful. This home is located in a quiet

residential area of large older homes. The individual from

whom the house is leased had formerly used it as a nursing

home by adding a wing to one side of the house. Up to

twenty older people may live here, either in the main house

or in "the wing." Most of the residents share a room with

another person and share a bath with the adjoining room. A

manager/couple and a housekeeper live in this home.

(3) Country Home is an imposing three-story brick man-

sion, formerly a private dwelling for one of the area's

pioneer families. Located in a rural area near the small

town of Winter Garden, this home is surrounded by several

acres of well-kept trees and lawn. As many as eighteen

residents can be accommodated here., either in the main house

or in three bedrooms built over a garage in the back.' Three

of four staff members may reside in this home.

During the six months of participant observation the

researcher lived in one of the three primary sites and spent

part of each day observing and interviewing in one or more

of the other homes. The physical proximity of the homes

made dropping in and out of the settings very convenient.

Understandably, however, the most complete and detailed

observations come from those homes where the researcher

actually lived. The necessities of day to day living ordi-

narily result in more involvement by the fieldworker in her

places of residence (Pelto, 1970:215).








The virtue of using comparison groups in social science

research has long been recognized. Certainly in the present

research being able to observe and participate in several of

the homes provided the opportunity to conduct the kind of

theoretical sampling recommended by Glaser and Strauss

(1967:55). Theoretical sampling is accomplished by pur-

posely choosing groups to observe on the basis of presumed

likenesses and/or differences with the goal of checking out

one's emerging conceptual categories or hypotheses.

All the Share-a-Homes are similar in some ways; the

requirements for entering the homes and staff respon-

sibilities are alike, for example. However, using ten cases

does provide for some variability in other important proper-

ties and characteristics.


The Population

Both the elderly people who live in Share-a-Homes and

the live-in staff who are employed there are "residents" of

these settings. However the term will hereafter be used to

refer to the elderly residents only.

During the initial stages of fieldwork, the researcher

obtained lists of the current population within each home.

At that time ninety-seven older people lived in the ten

homes, with as few as four in one home and as many as six-

teen in several of the largest homes. These ninety-seven

were treated as the "core group" throughout the research.








However, turnover was high in some of the homes and so the

population was constantly changing. This core group of

ninety-seven was followed both to demonstrate this turnover

and to provide a demographic profile of the Share-A-Home

population at one point in time.

The ninety-seven residents consisted of seventy-six

females and twenty-one males. The average age for both

sexes was about eighty years. The youngest resident was in

her early sixties and the oldest in her middle nineties.

All of the residents were white and most were widowed.

There were four married couples included in this core group.

During the research a lengthy formal interview was con-

ducted with fifty-one of the core group of residents. The

original plan was to interview as many of the residents as

possible. However, while the interview was attempted with

an additional thirty-three residents they were unable to

respond to the long, comprehensive interview because of sen-

sory defects, illness or mental impairment. Therefore, a

shortened form of the interview was designed. As much

information as possible was gathered from the resident and

sometimes from staff members.

Of the remaining thirteen residents, nine refused to be

interviewed and four had already left the home and no

reliable informant could be found. The staff in

Share-a-Homes consists of both live-in staff and others who








are employed on full or parttime bases and who do not reside

in the homes. Staff interviews were conducted with less

formality than were resident interviews. However a semi-

structured interview was conducted with the five live-in

staff in the three primary research sites.


Sources of Data

The primary source of data for this dissertation is the

field notes kept by the researcher during her fieldwork.

Notes concerning observations and conversations with resi-

dents and staff were usually recorded in private several

times each day and later typed in triplicate. Every attempt

was made to record impressions and comments as soon as

possible to avoid the distortion caused by gaps between the

event and the recording of that event.

A number of informal interviews with residents who

served as key informants in some of the homes were con-

ducted. Ordinarily these interviews focused on one or more

specific topics and the researcher openly took notes during

these interviews.

Formal interviews with the residents began about two

months after the researcher began living in the homes and

were completed in about six weeks. An interview guide was

developed which would yield a more systematic description of

the personal and social characteristics of the residents as

well as more comparable information on some specific themes

which emerged during the early months of fieldwork.








The interview guide consisted of both forced choice and

free response questions. The interview was usually con-

ducted in the resident's bedroom and ordinarily took from

one to two hours to complete. In several cases the inter-

view had to be completed in two sessions as the residents

either made very lengthy responses or because they grew

tired before the end of the interview.

The entire interview was completed by fifty-one of the

residents. These tended to be the healthier and more alert

group members. Only the first half (Parts A through D)

of the interview guide was used for most of the remaining

residents. The questions in this section focused primarily

on basic background information, health statuses and func-

tional capacities of these less able residents. (Appendix A

contains a copy of the interview guide.)

Informal interviews were conducted with both live-in

and other staff members in all of the homes. The five live-

in staff in the three primary research sites were inter-

viewed using a semi-structured interview guide. (The list of

questions used in these interviews may be found in Appendix

B.)

Several other sources of data were also employed. The

Share-A-Home Association keeps written records of only the

most basic information on the residents. The researcher was

permitted access to these records on both current and past








residents; these revealed some useful information about ages

at entry and departure, former place of residence and turn-

over rates. Other records and reports kept by the

Association, such as financial records, were also examined.

Transcripts of taped staff training sessions and promo-

tional speeches given by the Association's administrator

were useful sources of organizational philosophies, goals

and procedures. Mass media materials including both local

and national newspaper and magazine articles, and tapes of

one local and one nationally broadcast television shows were

also helpful.


Data Collection and Analysis

The separation of data collection and data analysis in

describing the methodology of this particular type of

research is an artificial one. Analysis actually begins

from the first day the researcher enters the setting and

continues throughout her involvement there. Glaser and

Strauss (1967:113) suggest the method of constant com-

parisons as a way to systematically conduct data collection

and data analysis concurrently; this method was adopted for

the research reported here.

The constant comparative method has basically two com-

ponents. First, as field notes are recorded the researcher

begins to code the data into conceptual categories. In this

research the codes for these emerging categories were








written in the margins of the field notes. Second, the

researcher engages in a constant recording of ideas about

the data and the categories that are being identified. In

this research, some theoretical notes or memos were recorded

in the field notes but were clearly separated from the

recording of daily observations. Other memos were kept in a

separate notebook.

The concurrence of data collection and analysis allows

the researcher purposely to pursue instances of an event in

order to achieve "theoretical saturation" (Glaser and

Strauss, 1967:61-64). Theoretical saturation occurs when

the categories and the properties of these categories have

been so fully developed by repeated observations and other

sources of data that no new evidence is being discovered.

Theoretical sampling, described earlier, is a major

method of achieving theoretical saturation. For example, in

the research reported here, one obvious category within the

data which emerged immediately was that of resident-staff

relations. Developing the properties of this category meant

comparing resident-staff relations in homes that varied in

size, in the characteristics of the residents, in the

backgrounds of the staff, in resident and staff turnover

rates and in other characteristics.

The mass of qualitative materials which resulted from

notes taken in the field and during staff training sessions,








and from assembling newspaper and magazine articles and

tapes of TV shows, was organized and reorganized according

to major themes or core conceptual categories which emerged

throughout the course of the research. One copy of all the

qualitative materials was kept intact while another was

separated and filed according to one or more conceptual

categories. Still a third set was filed according to the

specific home to which the data applied.

The interviews were treated as one "slice" of data

(Glaser and Strauss, 1967:67-68), and responses to open-

ended questions were coded and filed according to the same

categorical system used with the other qualitative data.

The interview data were also punched onto cards and simple

analyses were accomplished using the SPSS computer system.

The result of these procedures is an empirically

grounded explanation of the phenomenon which is developed

on a variety of "slices" of data. The findings of this

research are organized into a thematic presentation. Such

major themes reflect the nature of the key components of

social life in these settings.


Data Quality Control

Like all research methodologies, participant observation

is faced with the problems of maintaining high data quality.

That is, the procedures should yield consistent and valid

data in which one may have real confidence. In some ways








participant observation has advantages over survey and

experimental designs. The simultaneous activities of

gathering data, analyses and conceptualization allows the

researcher to discover and compensate for any possible

threats to the interpretability of the data (McCall and

Simmons, 1969:127).

However, observational methods are particularly suscep-

tible to several contaminating effects which threaten the

validity of the findings. These include reactive effects of

the observer's presence on the phenomenon under study,

selective perception and interpretation by the observer and

the inability of the observer to observe the entire phenome-

non (McCall and Simmons, 1969:128).

In the research reported here, a number of tactics have

been employed to lessen these threats to interpretability.

First, the triangulation of methods, described earlier, is a

technique used to gather different types of data on the same

subject which can act as mutual checks (Glaser and Strauss,

1967:18). Multiple observations of events over an extended

period of time in the ten homes also serve to enhance con-

fidence in the data (Becker, 1970:54).

Certainly in this study, as in all participant obser-

vation research, the observer and the observed exerted

mutual effects on each other (Schwartz and Schwartz,

1969:89). These effects have been treated as integral parts








of the data and used in analyzing these social settings.

The researcher consciously assumed the "student-child" role

(Agar, 1980:204) in these homes. This enabled her to deve-

lop a special kind of rapport with nearly all the residents

and to gain information that is not typically forthcoming to

other outsiders. The assumption of this role may also have

closed off certain types of information, too, as not fit

for the "student-child's" ears. Yet the researcher became a

fixture in these settings after a while and took part in

numerous conversations about sensitive topics.

Actually living for twenty-four hours a day in these

homes afforded views of both the public and the private

faces of residents and staff. For example, the researcher

was in residence during the filming of a television documen-

tary in one of the homes and was able to compare behaviors

in front of outsiders with everyday behaviors. Given the

small, self-contained nature of these shared homes and the

limited number of possible settings for action, it is likely

that most of the backstage areas of life there became known

to the researcher.













CHAPTER FIVE

THE SHARE-A-HOME MODEL: BACKGROUND AND PARTICIPANTS



The Share-A-Homes in Florida are examples of one model

of shared living for older people. This particular model has

been in existence since 1969, and is well established in the

Central Florida area. In the first section of this chapter

the history of the model and the philosophy of those who

established and maintain it are presented. Particular

attention is given to the beliefs and ideas about older

people that are held by the administrative staff of the

Share-A-Home Association. In the second part of the

chapter, the policies and procedures that are shaped by

these beliefs are described. In the final two sections the

two major groups of participants in these homes, the resi-

dents and the staff, are introduced. Subsequent chapters

will describe and analyze the social life which these par-

ticipants construct in these shared living settings.


History and Ideals

The homes in which the field study was conducted are all

under the general sponsorship of the Share-A-Homes of

America Association which is chartered as a non-profit








corporation. The Association is composed of a board of

directors made up of interested persons from the local com-

munity. The Association employs a General Manager who coor-

dinates the staffing of all the homes and deals with other

administrative matters; the founder of the first Share-A-

Home has been employed as the General Manager since the

Association was started in 1972.

The founder and General Manager of the Association is a

religiously motivated man who believes that older people can

create a "family" together and can live the kind of communal

life that is described in the Bible. He has spent the last

decade starting new homes in his own community and helping

other non-profit groups to start them in other parts of the

United States. Although the Association has no formal con-

nection with any church or denomination, the establishing

and maintaining of the homes is viewed as a "Christian

mission."

The formally stated goal of the Association is the

creation of residences for older people which maximize inde-

pendence while providing "family-like" support.

Considerable attention is given in the Association's public

relations literature to the non-institutional features of

these homes. According to a brochure describing the homes,

living in a Share-A-Home means "a way of life that allows

older people to retain their dignity and self-respect in an








atmosphere of compassion and love. where there are

no institutional constraints." The brochure describes each

home as "a legally recognized family of non-related

individuals" rather than "a nursing home. or a retire-

ment home. or a commercial establishment."

Staff training sessions conducted by the administration

reveal a strong commitment to the "family" ideal. The

founder and General Manager in particular emphasizes this:

I still take big exception when one of my
staff members say anything about the
patients down the hall, or this patient
or that patient, because we have no
patients in Share-A-Home and I still have
trouble getting across the concept that
we are a family I don't rent rooms.
This is not a boarding house or a motel.
We provide a home for a family. We're
not an institution in any way shape or
form. We are a family. .

The claim by the Association that these homes are

legally recognized "families" is based on the outcome of a

lawsuit filed against the original home in 1971. The suit,

brought by neighbors of the home, charged that a boarding

home was being operated in a neighborhood zoned exclusively

for single-family dwellings. However, the circuit court

judge who heard the case found that the home did meet the

definition of "family" as set forth by the local zoning

board as "one or more persons occupying a dwelling and

living as a single housekeeping unit. ."

Following the court's decision, the Association grad-

ually began to establish other "families" throughout the



Orange County Florida v. Share-A-Home, No. 71-3319 (Ninth
Judicial Circuit, Orange County, Florida, Filed September
28, 1971).









county. By the summer of 1978, ten separate homes were in

existence. Each of the homes has its own live-in staff and

there is little direct contact among the residents of

other homes. The General Manager and his small administra-

tive staff usually have daily contact with the staff in all

the homes; this provides a link between the homes. Staff

also sometimes substitute for each other in the homes.

The General Manager professes a strong commitment to the

autonomy of the "families" which he believes would be

compromised by governmental interference. He is very resis-

tant to the idea that the "families" should be fitted into

one of the several categories of group living facilities

established by the state agency charged with licensing and

regulating such facilities. Thus far the Association has

established and operated the homes without a formal confron-

tation with this state agency over the issues of licensure

and regulation.

The Share-A-Home Association is committed to providing

safe and pleasant homes for older people who cannot live

completely independently for one reason or another. The

Association's beliefs about what these older people need and

want are clearly articulated by them: older people do not

wish to be burdens on anyone, and they very much want to

feel loved, secure and protected. The General Manager tries

to communicate this in training sessions with new staff:








This is one question that always comes up
--how can you create a family from diverse
people? The answer is--the need for
love and security. The children, friends
and associates of these people are all
gone. They are alone. Being alone
is the worst disease in the world. .

There is a strong belief that these older people desire

a sense of continuity with the past and that they resist

sudden change. For change causes anxiety and this must be

avoided according to the General Manager:

Staff must dispel anxiety in old people.
Living without anxiety is necessary.
Anxiety is a major problem of
old people. It causes physical and men-
tal problems. Our job is to pro-
tect old people.

Protecting the residents involves providing a place to

live in which they are not alone and in which they may move

about in safety and security. It also involves making sure

that the residents have good meals and that they seek medi-

cal attention if necessary. Staff are instructed to be

aware at all times of even the most subtle changes in a

resident's appearance or habits which might suggest some

problem or illness. Although the residents are generally

healthy, and staff often have no medical training or

experience, this need for constant awareness of residents'

physical and mental states is emphasized repeatedly to

staff.

In addition to protecting residents by providing needed

services and by paying close attention to their well-being,








the Share-A-Home Association often consciously assumes the

role of buffer between the resident and the natural family.

It is believed that older people do not want to live with

their adult children, and that when they do, serious

problems are certain to arise. Shared living is thought to

provide a way for the frail elderly person to live indepen-

dently of her children without the stigma of living in a

nursing home and without the resentment and tensions that

inevitably arise when old parents live with children. The

General Manager often expresses his belief that living in a

Share-A-Home permits old people to maintain close ties to

their families.


Procedures and Policies

From the Share-A-Home's commitment to the creation of

"families" of older people and from their beliefs about the

major needs of the older population they serve have come a

body of procedures and policies. Many of these are fairly

explicit although few are in written form. Since these are

"families," not institutions, the administration often com-

ments on what they perceive as the absence of formal poli-

cies and modes of operation. Nevertheless, from the very

outset of this research, the administration expressed the

hope that an operational manual which could be used in staff

training might be a major product of the research project.

(See Streib and Hilker, 1980.)








The Provision of Services

Included in the monthly contribution (the admin-

istration declines to call this "rent") made by each resi-

dent are a number of services in addition to the actual

shelter. The homes provide no nursing care nor do they have

any formal ties with any physician or medical facility.

Personal care such as help with bathing or dressing is not

one of the services that the staff are ordinarily expected

to perform as all residents are supposed to be able to do

these things for themselves. Those services which are pro-

vided for all residents are

(1) all meal preparation and service in a communal

dining room;

(2) all housekeeping, including residents' bedrooms if

they so desire;

(3) all laundry, including personal clothing, and

linens which are provided by the home;

(4) transportation to various appointments and to

shopping, using the home's own vehicle;

(5) the presence of staff on a twenty-four a day basis,

with at least one staff member residing in the home.

Residents have no choices as to which of the services

they wish to pay for and which they would prefer to forego.

They may decide to do their own laundry, to drive their own

cars to appointments, or eat their meals in restaurants, but








they still pay the same amount each month. The result is,

of course, that nearly all of the residents do accept all of

the services available. Even without the provision of any

kind of health or medical care, Share-A-Homes would be con-

sidered, in the language of the long-term care literature,

"service-rich" settings.

In their very self-conscious attempts to avoid

resembling old-age institutions and to provide a sense of

continuity with earlier and more independent times, the

administration carefully instructs its staff in a rather

lengthy but unwritten list of do's and don't. One set of

examples has to do with food--from menu-planning and gro-

cery shopping to meal preparation and service. The admin-

istration believes that one of the greatest pleasures still

remaining to older people is the enjoyment of good food, and

so considerable time and energy are spent on food-related

matters.

The live-in house staff do the meal planning and grocery

shopping each week. Menus are not posted; a resident merely

asks what is going to be served if she wants to now. The

large institutional sized cans of food are not bought; the

administration feels that the pantry should look like any

family's pantry, not a nursing home's. Food preferences are

considered, although there is rarely a choice of entrees;

however, some of the homes are known for having residents








who hate liver or dislike fish and these items are never on

the menus there.

The biggest meal of the day is served in the evenings,

unlike in nursing homes where the largest meal is often

given at noon. Staff are given numerous instructions about

what foods to serve at which meals: jello at the evening

meal is too "institutional"t putting the dessert out before

the meal is over likewise has hospital or nursing home con-

notations. In these and in other ways the staff is supposed

to try to convey an atmosphere of normalcy and "family" to

mealtimes.


General Policies

The official policy-making body of the Association is the

Board of Directors. This board is particularly involved in

public relations and financial matters, while the actual

day-to-day running of the homes is left to the General

Manager and his small administrative staff. The administra-

tion has a great many unwritten but understood policies

which pertain to staff and to residents.

Finding and keeping staff consumes considerable admin-

istrative time. While there are no specific job qualifi-

cations, there are some definite notions about what

characteristics a good staff member should have.

Individuals or married couples seeking employment should be

"mature," "caring," and "patient." Staff are often referred








to by the administration as "servants of the people," and as

the General Manager has stated, "Staff is part of the family

as servants in past times were part of the family."

Policies regarding new residents are more specific. A

potential resident must be able to care for her personal

needs, be ambulatory (wheelchairs are not permitted), be

able to pay the monthly fee, and not be in need of nursing

care. Because these are "families," there are few records

kept on the residents; a brief form is completed at the time

of the application which contains only the most basic infor-

mation such as names and phone numbers of personal physi-

cian, next of kin, and the person designated as the power of

attorney, and medication and special diet requirements.

Even though the founder of Share-A-Home describes his as a

"Christian mission," there are no requirements that one be a

Christian to enter one of the homes. Although each of the

homes displays a Bible and a cross in a conspicuous place,

there is otherwise nothing particularly "Christian" about

the homes. Non-Christians are readily admitted into the

homes if they meet the basic requirements.

The administration does not believe in keeping records of

instances of hospitalization, illness or other major events

that may occur after a person enters the home. While insti-

tutions may keep such records, the General Manager stated,

"It is not our business to pry into their personal lives."








The only written information about a resident that is kept

in both the home itself and the administrative office are

emergency phone numbers and diet and medication information.

There are a few set conditions under which an individual

must end her residency in the home. If her health becomes

such that she needs constant medical supervision, or if she

becomes incontinent or non-ambulatory, she is usually

required to seek other living arrangements. Other

situations are less clear-cut, such as cases where the resi-

dent become confused and occasionally wanders away from the

home, or becomes obstreperous and difficult to live with.

The final decision in any case usually comes about as a

result of negotiations among the administration, the house

staff, the resident and her family, her personal physician,

and the other residents of the home. According to the

administration, the personal physician has "the final word"

as to whether the Share-A-home is still an appropriate

residential setting.

In keeping with its "family" ideology, the Share-A-Home

administration tries to avoid setting down rules or proce-

dures that must be followed by the residents of the homes.

"House rules" do emerge, of course, although these are not

in written form. The content of these rules and how they

operate in the social life of the homes will be discussed in

a later chapter. What is important to note here is that








there are no formal policy-setting bodies inside the indivi-

dual homes--no residents' councils, no regularly scheduled

house meetings and no designated residents to act as

representatives to the staff and/or administration and/or

the Board of Directors. The rationale given by the

administration is, again, that these are "families," not

institutions and such things are therefore inappropriate.

The overall viewpoint of the administration is that resi-

dents should be able to conduct their lives as they choose

unencumbered by institutional-like rules. At the same

time, the sensibilities of others must be taken into account.

Thus, while there are no rules against drinking alcoholic

beverages in the homes, the staff are instructed to tell

those residents who are so inclined that they must drink

only in the privacy of their rooms, never in the communal

areas of the home.


Participants: The Residents

The world of Share-A-Home is primarily a world of older

women; for that reason the personal pronoun "she" is used in

this report. While there is considerable variation among the

ten homes as to the number of male residents, in none of

them are males in the majority. Most of the women are in

their late seventies and early eighties and are retired

homemakers, white collar workers or professionals. The male

residents are slightly older and are retired salesmen, or








skilled or semi-skilled workers. The typical resident is

widowed, has at least one adult child living nearby, and is

of the Protestant faith. All the residents living in the

homes during the six months of participant observation were

white; to the researcher's knowledge no black individuals

have ever been residents in any of the Florida homes.

According to the administration, no blacks have ever con-

tacted their office about becoming residents.

The majority of these residents of shared homes are,

then, white, middle-class, older women. Since the admin-

istration felt that the researcher's asking the residents

to give their annual incomes would be regarded by them as a

serious invasion of privacy, only indirect questions about

financial matters were included in the formal interview.

Only five of the fifty-one persons interviewed felt that

they had such severe financial problems that they were just

making ends meet. The others stated that they had all the

money they needed to feel financially secure.

Primary sources of income were Social Security, other

pensions, savings and other assets; only two residents

received SSI (Supplemental Security Income). About one-half

of the core group of ninety-seven residents paid their

monthly contributions, which averaged $400, entirely from

their personal incomes; for about 40 percent, thirty-eight

residents, their own funds were supplemented in varying








degrees by their families, usually adult children. Other

sources of support for the monthly contribution came from

private organizations such as churches; this applied to only

a few of the residents.

Most of the residents resided in the state of Florida

before moving into one of the homes; many were longtime

residents of Orange County. They were typically living

alone or with a spouse or other family member before the

move; only a few came from nursing homes or other institu-

tional settings. Most of the residents moved into the homes

because living alone had become impossible to manage, or

because their spouse or other family member had died or

become incapacitated. Their personal physicians often

suggested that they seek some type of group residential

setting, and adult children often made the initial contact

with the Share-A-Home office on behalf of their parent.

Among the core group of ninety-seven residents iden-

tified at the beginning of the study, the length of stay in

the ten homes ranged from one month to six years with a

median length of twenty-one months. In the oldest of the

homes, which had been opened since 1969, the average length

of residence for the seventeen individuals living there at

the start of the field work was two years and three months.

One year after the study began, ten of these ninety-seven

individuals were known to have died, nineteen had moved into








nursing homes, and eight had moved to boarding homes or

other group residential facilities, and two had moved in

with adult children.

The records kept by the administration are minimal, but

the dates of admission and termination of all previous resi-

dents were obtained during the latter part of the field

study. This permitted calculation of how long individuals

generally remained in these homes before they died or moved

elsewhere. Unfortunately, there are no records indicating

where these individuals went when they left Share-A-Home.

Two hundred and twenty-three persons were identified as pre-

vious residents in the period 1969-1978. Thirty four per-

cent, 75 people, remained a resident in one or more of the

homes for less than four months. Thirty five percent, 77

people, stayed from four months to a year while 20 percent,

43 individuals, remained from one to two years. Less than

15 percent, 28 people, lived in the homes longer than two

years.

Applicants to the homes are not admitted if they have

medical problems which might be more appropriately treated

in a residential setting having a medical component.

Therefore, the residents appear generally healthy,

although chronic conditions such as arthritis, high blood

pressure and heart disease are not uncommon. Since there

are no medical records kept, the only sources of information








about the health statuses of the residents are their self-

reports and the researcher's observations and interviews

with staff. Of those fifty-one who took part in the full

interview, three-quarters rated their health as good or

excellent, and nearly everyone felt that his or her health

was as good or better than others of the same age. Only

a few felt that their health problems limited their activi-

ties in any significant ways.

Only about one quarter of the fifty-one residents

reported spending any time in a hospital during the previous

twelve months. However, evidence based on staff reports

suggest that those residents who were unable or unwilling to

participate in the comprehensive interview were less healthy

and more likely to have spent some time in the hospital in

the previous year than those who did participate. It is

estimated that at least one-half of the former spent some

time in the hospital in the previous year.

About two-thirds of the core group of ninety-seven resi-

dents reported taking prescription medications. While a few

of the residents kept their medications in their rooms and

took them without assistance, nearly everyone else turned

them over to the home's manager to be dispensed at the

appropriate times. While there are no rules to that effect,

the latter procedure is preferred by the Share-A-Home

administration since it insures that medications are taken

regularly and in the correct dosages.








Most of the residents of Share-A-Homes are able to care

for all their personal needs, such as bathing, dressing,

toileting and so forth; this is a definite requirement for

admission to the homes. However, staff reports and

researcher's observations suggest that a small percentage,

perhaps 10 to 15 percent of the entire resident population,

do receive some assistance in personal care, usually in

fastening clothing or in getting in and out of the bathtub,

or in cutting up food. These are usually residents who have

lived in the homes for some time and are beginning to falter

in their capacity for self-care or else are residents who

are recovering from some illness or surgery. The assistance

may come from staff, but more often it comes from other

residents, particularly from roommates.

Although the residents are not required to perform any

housework, cooking or other such tasks, those residents who

participated in the comprehensive interview were asked to

judge their present capacity to manage the tasks of indepen-

dent living; Table Two shows the results. While relatively

few residents felt they could manage all the housework,

shopping, meal preparation and laundry without help, a con-

siderable percentage felt they could accomplish these things

given some help. Doing the laundry would apparently

present serious problems for one-third of the residents

interviewed. Forty-three of these fifty-one residents do








make their own beds every day without assistance, although

the housekeeper will do this for them if they prefer.



TABLE TWO


Perceived Capacity for Independent Living Tasks


Housework


Short-i n1


Meal
re v a -raio 4


T.L and V 7


% N % N % N % N


Completely 21.0 11 24.0 12 27.0 14 33.0 17
Unable to do


Could do with 61.0 31 45.0 23 47.0 24 45.0 23
some help


Could do with 18.0 9 31.0 16 26.0 13 22.0 11
no help


Total 100.0 51 100.0 51 100.0 51 100.0 51


As another indicator of self-care ability, the residents

were asked if they managed all their financial affairs inde-

pendently. Nineteen of these fifty-one residents did so,

while twenty managed with some help from a family member

and ten had turned over the management of all or most

money matters to a family member. In the latter cases no

formal guardianships had been established, only informal








arrangements between the resident and, in most cases, an

adult child.

It should be noted that those fifty-one residents who

took part in the long version of the interview tended to be

not only the most cooperative, but also the healthiest and

most alert. Therefore the description of functional

capacities of this particular group should not be taken as

representative of the entire population since the more

seriously impaired residents were not asked to respond to some

of the questions.

Residents varied widely in terms of mental functioning.

While no attempt was made to either obtain or infer functional

or organic mental disorder, the researcher did make use of

the Intellectual Functioning Rating Scale developed at the

Philadelphia Geriatric Center.- (See Appendix C for a copy of

this scale.) This instrument may be used by a rater without

psychiatric training and is useful in distinguishing indivi-

duals on the basis of some of the indicators thought of as

"normal aging," and those that suggest some pathology.

The Intellectual Functioning Rating Scale was completed

for the sample of fifty-one and also for every resident

identified as part of the original core group with whom the

researcher had sufficient contact over the six month period

to make an assessment of his or her mental functioning.

Table Three shows that the large majority of the sample of








fifty-one were given ratings of "1" (intact mental function,

capable of full participation in planning and exercising

good judgment in decision-making) or "2" (mental function

is substantially intact, capable of participating in

planning and decision-making with only minor dependence on

others); forty-five residents received one of these two

ratings. Six of these residents were assigned ratings of

"3" or "4" which indicate some deficit in mental functioning

but not so serious that daily living routines require the

constant supervision of others. None of these residents in

the sample of fifty-one was assigned a rating of "5," indi-

cating severe memory loss and disorientation and the need

for round-the-clock care.

The rating scale was also completed for thirty-two of

the remaining forty-six residents in the core group.

Seventeen were assigned a score of "1" or "2" while eleven

were assigned either a "3" or a "4." Four were assigned a

rating of "5"; these individuals manifested gross memory

impairments, confusion as to where they were, who others

around them were, serious deterioration of personal habits,

and irrelevant or meaningless verbal communications. In the

remaining fourteen cases, the researcher did not feel con-

fident enough to assign a mental functioning score.









TABLE THREE


Scores on Intellectual Functioning Rating Scale *


Residents
Interviewed
(N=51)


Score


Residents Not
Interviewed
(N=46)


Total Residents
(N=97)


% N % N % N


59.0


(Intact Mental Function)


29.0


15.0



22.0


(Mental Function Substantially Intact)

3 10.0 5 4.0 2

(Occasional memory losses, not disoriented)

4 2.0 1 20.0 9


(Memory defects, not
needs some personal

5 0.0


(Severe memor

Cannot Judge


disoriented,
supervision)

0 9.0


y loss and disorientation)

0.0 0 30.0 14


100.0 51 100.0 46


38.0



26.0



7.0



10.5




4.0



14.5


100.0


*Source: Philadelphia Geriatric Center, Philadelphia,
Pennsylvania.








Participants: The Household Staff

Every one of the ten homes in Central Florida employs a

manager or managing couple who reside full time in the home

and are responsible for seeing that domestic tasks are

accomplished. In the smaller homes the manager often does

all the housekeeping, shopping, cooking and laundry without

help, while in the larger homes other staff are employed to

serve as cooks or housekeepers. Live-in staff are paid a

small salary in addition to receiving room and board; "room"

in this case means exactly that--a bedroom usually directly

adjacent to residents' bedrooms. Rarely do live-in staff

have private bathrooms; these are usually shared either with

other staff members or with one or more residents.

Most of the managers reported having high school educa-

tions, but none were college graduates. None of the mana-

gers had any professional training in the field of aging,

although about one-half had previous work experiences that

were related to their current positions, such as nurse's aide

in a nursing home or manager of a mobile home park con-

sisting largely of older residents. At the beginning of the

field work half of the homes were managed by married couples

and the other half by women alone. The couples were middle-

aged or older; two of these couples were themselves past

retirement age. The women managers were divorcees or widows

and two of them had a child living with them.








Two of the managers were long-time employees of

Share-A-Home and had worked continuously for several years

in the same homes. The other managers had been employed in

the homes for one year or less. Turnover is high, with seven

out of the ten homes having different managers by the time

the six months of participant observation was completed.

Finding and keeping dedicated managers is seen as a major

problem by the Share-A-Home administration.

The other domestic staff, the cooks and the housekeepers

in the larger homes, were all women and ranged in age from

the early twenties to the sixties. In the largest homes one

or more of these staff resided there on a full time basis

just as the manager did, receiving room and board and a

small salary. Most of these women had previous work

experiences as either cooks or housekeepers and a few had

worked in the homes for several years. However, turnover

among these staff was constant, and some of the houses had a

rapid succession of cooks and/or housekeepers during the

period of the fieldwork. Of the twelve cooks and house-

keepers employed at the start of the study, only three were

still working six months later.

The Association was participating at that time in a

program in cooperation with-a local private agency serving

unwed mothers. Several young women lived and worked as

housekeepers in a number of the homes for the duration of








their pregnancies. A few of these women remained in the

employ of the homes after their babies were born, placing

the infants in nurseries during the day while their mothers

worked. As a result, several of the homes had small

children or infants in residence during the field study.


Overview

The shared homes under study are sponsored by the

Share-A-Homes of America Association, a non-profit cor-

poration made up of a board of directors from the com-

munity and a small administrative staff. The founder of the

Association also serves as the General Manager, or chief

administrator, of the ten homes. The main goal of the

Association is the establishment of "families" of older

people who cannot live totally independently but who do not

require institutional placement. Founding and maintaining

such homes is viewed as the "Christian mission" of the

Association, although people of non-Christian faiths are

welcomed as residents.

The Association's beliefs, particularly those of the

founder, about older people's needs and desires have shaped

Share-A-Home procedures and policies. Older people are

thought to need security and love and at the same time to

feel that they are living independently. Share-A-Home staff

are instructed that their job is to give residents a sense

of being protected but without the constraints of institutional








living. Consequently there are no written rules or

regulations for the "family" member to follow and conscious

attempts are made to create a just-like-home atmosphere.

Almost no written records are kept on residents and

initiating and ending residency are handled very informally

among the administration, staff, resident and her family,

her personal physician and the other residents of the home.

The older people who live in these homes are mostly

widows in their seventies and eighties who come from middle

class backgrounds and, although not wealthy, neither are

they poor. Nearly all of the residents are able to care for

all their personal needs, a requirement for entry, and the

majority could be described as mentally intact, capable of

decision-making and planning. The average length of resi-

dence for the group of residents identified as the core

group at the beginning of the study was twenty-one months.

Each home employs a manager or a managing couple who

coordinate the running of the home. In the small houses

the manager does all of the domestic work herself while in

the larger homes cooks and/or housekeepers are employed to

assist the manager. The manager is required to live

fulltime on the premises and in the largest homes at least

one other staff member also lives in. Managers do not

have professional backgrounds in aging, but a number reported

having some related job experience. Turnover among all





89


staff is high, particularly among the cooks and house-

keepers, and this is perceived as a serious problem by the

Share-A-Home administration.













CHAPTER SIX

EVERYDAY LIFE IN SHARED HOMES



This chapter presents a description of some aspects of

daily life inside these shared homes. How the daily activi-

ties of living are accomplished is clearly influenced by

the Share-A-Home "family" ideology; the ways in which this

is so are suggested throughout this chapter. The socializa-

tion of new residents, daily routines, contact with family

and friends outside of the homes, and community involvement

are described using both observational and interview data.


The Share-A-Home Technology

Six months of participant observation in the ten shared

homes in Florida resulted in detailed knowledge about how

the participants, both residents and staff, conduct their

everyday lives in these settings. Although there is con-

siderable variation in size and structure, and although they

are composed of many different combinations of personalities

and functional and mental capacities, there is also a cer-

tain sameness about the homes that would be noticed by even

the most casual observer. For partly in spite of, and

partly because of, the family model utilized by the








Share-A-Home Association, there is a well-developed body of

methods or techniques involved in operating the homes. That

is, regardless of the home in which the researcher chose to

spend her day, she could usually accurately predict a great

deal about the daily routines of the staff and, to some

extent, of the residents. Such a technology makes staffs'

substituting for each other relatively easy. It also makes

adjusting easier when a resident must move from one home to

another, something that happened several times during the

field study.

This Share-A-Home technology is passed along from the

administration to the house managers who, in turn, pass it

along to the rest of the house staff. The administration

depends primarily on its more experienced managers to train

new managers by spending a few days with them instructing

them on the job. This is not to say that there is no flexi-

bility in terms of how staff may do their jobs, but the

administration is very insistent about certain aspects of

daily routines inside the homes.

Some of the content of this Share-A-Home technology with

regard to meals was mentioned in an earlier chapter on

administrative policies and procedures: certain kinds of

foods should be served at certain meals and in certain ways

to avoid an institutional atmosphere. Mealtimes are

actually the only rigidly scheduled events in the residents'








lives, with lunch and supper being served at set times.

Breakfast, however, is a flexible meal and residents may

choose to eat anytime between 7:30 and 9:00 a.m. which suits

them. Actually, only a few took advantage of these flexible

hours, with most sitting down to breakfast promptly at 7:30.

Food is served onto the plates by the kitchen staff and

brought out to the residents who are seated at small tables

for four to eight people. Only in one of the smaller homes

were meals served family style, and this was at the request

of the six residents who indicated to the researcher that

they had done it that way all their lives. The rationale

behind the filling of plates by the staff in the kitchen is

that, first, older people might not be able to handle hot,

heavy dishes and second, that everybody received an adequate

serving of each of the foods being served. A staff member

in one of the larger homes also admitted that it was simply

faster to dish the food up in the kitchen and it saved on

washing up serving dishes, too.

Staff eat their meals in the kitchen after the residents

have been served. While in none of the homes do the staff

sit at the residents' table during the meal, in some the

managers often sit there after the meal and chat and

drink coffee with the residents. Similarly, residents in

many of the homes go into the kitchen and sit down at

the table where the staff are finishing their meal and talk