title: Visitors and Resident Autonomy: Spoken and Unspoken Rules in Assisted Living.
abstract: This article explores resident autonomy in assisted living (AL) and the effects that visitors and visiting the AL have on that autonomy. We examine formal and informal policies that govern visiting in AL, stakeholders' views and enforcement of these policies, and the complex arrangements that visiting often entails in everyday life in the setting.
  
  
  
  Data are drawn from a multiyear ethnographic study of autonomy in AL. Research from multiple sites included participant observation, informal and in-depth, open-ended interviews of various stakeholders, and the writing of field notes. Research team biweekly discussions and the Atlas.ti software program facilitated coding and analysis of interview transcripts and fieldnotes.
  
  
  
  Our ethnographic data highlight complicated factors related to visitors and visiting in AL. We discuss two important aspects of visiting: (a) formal and informal policies at each setting; and (b) how resident autonomy is expressed or suppressed through rules about visiting in AL.
  
  
  
  Our data underscore the importance of resident autonomy and quality of care in relation to visitors and visiting, especially how this relationship is affected by inconsistent and confusing formal and informal visiting policies in AL.
authors.affiliation: Center for Aging Studies, Department of Sociology and Anthropology, University of Maryland, Baltimore County, Baltimore, Maryland.
authors.forename: Colleen R
authors.initials: CR
authors.lastname: Bennett
authors.affiliation: Center for Aging Studies, Department of Sociology and Anthropology, University of Maryland, Baltimore County, Baltimore, Maryland.
authors.forename: Ann Christine
authors.initials: AC
authors.lastname: Frankowski
authors.affiliation: Center for Aging Studies, Department of Sociology and Anthropology, University of Maryland, Baltimore County, Baltimore, Maryland.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Rubinstein
authors.affiliation: VA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center, Baltimore VA Medical Center, Baltimore, Maryland.
authors.forename: Amanda D
authors.initials: AD
authors.lastname: Peeples
authors.affiliation: Perez Consulting, Crofton, Maryland.
authors.forename: Rosa
authors.initials: R
authors.lastname: Perez
authors.affiliation: Center for Aging Studies, Department of Sociology and Anthropology, University of Maryland, Baltimore County, Baltimore, Maryland.
authors.forename: Mary
authors.initials: M
authors.lastname: Nemec
authors.affiliation: Center for Aging Studies, Department of Sociology and Anthropology, University of Maryland, Baltimore County, Baltimore, Maryland.
authors.forename: Gretchen G
authors.initials: GG
authors.lastname: Tucker
mesh_terms: D000884:Anthropology, Cultural; D040561:Assisted Living Facilities / Q000458:organization & administration*; D006801:Humans; D016134:Organizational Policy; D026684:Personal Autonomy; D036301:Qualitative Research; D058992:Social Participation; D012944:Social Support; D014789:Visitors to Patients
keywords: Environment or support; Formal and informal rules; Residential care; Social networks; Visiting