Institute for Health, Health Care Policy, & Aging Research, Rutgers, The State University of New Jersey, 536 George St. New Brunswick, NJ 08901,USA.
Gerontologist. 2012 Feb;52(1):1-12. doi: 10.1093/geront/gnr108. Epub 2011 Nov 9.
Initiatives to promote aging in place have emerged rapidly in the United States across various health care settings (e.g., acute care hospitals, skilled nursing facilities) and broader community settings (e.g., public social service agencies). Moreover, recent federal policies include a growing number of provisions for local efforts to promote aging in place. Despite emerging bodies of research that have described singular initiatives in their own right, there has been very little scholarship that forges conceptual linkages across this increasingly vast domain of research, practice, and policy. Integrative theory development is critical to ensure that aging-in-place initiatives do not become fragmented from each other. This article uses insights from ecological frameworks-specifically Urie Bronfenbrenner's bioecological systems theory and M. Powell Lawton's general ecological model of aging-to conceptualize a range of programs as aging-in-place initiatives and for describing their similarities and differences, particularly in terms of the features through which they intend to promote aging in place. Theoretically derived dimensions along which to characterize aging-in-place initiatives include environment-focused aspects (e.g., the types of social systems and structures that the initiatives target for change) and person-focused aspects (e.g., the extent to which the initiatives target particular subgroups of older adults). The article concludes with a discussion on how these theoretically derived dimensions can be used to advance and integrate research, practice, and policy to systematically develop and expand aging-in-place initiatives.
在美国，各种医疗保健环境（如急性护理医院、熟练护理设施）和更广泛的社区环境（如公共社会服务机构）都迅速涌现出促进就地老龄化的举措。此外，最近的联邦政策中包含越来越多的为促进就地老龄化而进行地方努力的规定。尽管已经有大量研究描述了各自的单一举措，但在这个研究、实践和政策日益广泛的领域中，几乎没有任何学术研究能够建立概念上的联系。综合理论的发展对于确保就地老龄化举措不会彼此脱节至关重要。本文利用生态框架的见解，特别是 Urie Bronfenbrenner 的生物生态系统理论和 M. Powell Lawton 的老龄化一般生态模型，将一系列计划概念化为就地老龄化举措，并描述它们的相似之处和不同之处，特别是在它们旨在促进就地老龄化的特征方面。用于描述就地老龄化举措的理论推导维度包括以环境为重点的方面（例如，计划针对变革的社会系统和结构类型）和以人为重点的方面（例如，计划针对特定老年人群体的程度）。文章最后讨论了如何使用这些理论推导维度来推进和整合研究、实践和政策，以系统地发展和扩大就地老龄化举措。
