title: The facade of stability in assisted living.
abstract: OBJECTIVE
  The study sought to identify the varied types of change arising from internal and external influences in assisted living (AL) settings, expanding upon the literature's limited focus on resident decline and staff turnover and clarifying the importance of changes to life and work there.
  
  
  METHODS
  This analysis employed qualitative interviews and observations from 4 studies involving 17 ALs to identify elements of change largely absent from the literature. Case material identified by the research team members relating to persons, groups, and settings exemplifying typical changes, as well as variations across settings, are presented.
  
  
  RESULTS
  Multiple domains of AL change were identified, to include those in: (a) the external economic or competitive environments; (b) ownership, management, or key personnel; and (c) physical health or cognition of the aggregate resident population. In many cases, the changes influenced residents' satisfaction and perceived fit with the AL environment.
  
  
  CONCLUSIONS
  Change of many types is a regular feature of AL; many changes alter routines or daily life; raise concerns of staff, residents, or families; or modify perceptions of residential normalcy. Environmental gerontology should more often extend the environment to include the social and interpersonal characteristics of collective living sites for elders.
authors.affiliation: Correspondence should be addressed to Leslie A. Morgan, Department of Sociology & Anthropology, UM1000 Hilltop Circle, Baltimore, MD 21250. E-mail: lmorgan@umbc.edu.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Morgan
authors.forename: Robert L
authors.initials: RL
authors.lastname: Rubinstein
authors.forename: Ann Christine
authors.initials: AC
authors.lastname: Frankowski
authors.forename: Rosa
authors.initials: R
authors.lastname: Perez
authors.forename: Erin G
authors.initials: EG
authors.lastname: Roth
authors.forename: Amanda D
authors.initials: AD
authors.lastname: Peeples
authors.forename: Mary
authors.initials: M
authors.lastname: Nemec
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Eckert
authors.forename: Susan
authors.initials: S
authors.lastname: Goldman
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000375:Aging / Q000523:psychology*; D000884:Anthropology, Cultural / Q000379:methods; D040561:Assisted Living Facilities / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008134:Long-Term Care; D008396:Maryland; D010549:Personal Satisfaction; D036301:Qualitative Research; D011788:Quality of Life; D057545:Social Stigma; D000078329:Workforce
keywords: Assisted living; Environmental gerontology; Long-term care; Quality of life.