Successful Administration of Senior Housing: Working with Elderly Residents
Publication Year: 1992
Subject: Social Work & Older Clients
Responding to the growing population of older persons and the subsequent interest in providing progressive living environments, Succcessful Administration of Senior Housing is a comprehensive resource offering an increased awareness of management strategies and tools to better respond to frailty among elderly tenants. This insightful volume outlines ways of better serving elderly tenants and highlights the importance of collaboration among housing managers, social service providers, and health care professionals to more effectively and humanely serve the needs of elderly renters. To date, housing professionals have received little concrete help or assistance from experts, public policymakers or gerontologists; Successful Administration of Senior Housing is a welcome addition that will help fill this void by outlining ways to better manage the complex problems and issues that emerge ...
- Front Matter
- Back Matter
- Subject Index
- Chapter 1: Introduction
- Purpose of this Book
- Framework: Person-Environment Transactions
- Chapter 2: Significant Trends Affecting Senior Housing
- The Demographic “Aging” Revolution
- Federal, State, and Local Initiatives to Provide Services in Senior Housing
- Changes in the Locus of the Long-Term Care Delivery System
- Chapter 3: The Changing Role of Housing Manager: Redefining the Role and Responsibilities of Housing Managers
- Who are Housing Managers in Senior Housing?
- Managing Senior Housing: A Unique Management Role
- Housing Managers as Care Managers
- Concerns about Housing Managers as Care Managers
- Guidelines for Care Managers Working with Elderly Tenants
- Other Roles for Housing Managers
- Promoting Autonomy among Elderly Tenants
- Boundaries: The Dimensions of the Housing Manager Role
- Chapter 4: Management Practices and Policies and Aging in Place
- Dimensions of Management in Senior Housing
- “Goodness of Fit” between Tenant Competence and Environment
- Assessment as Part of the Management Process
- Chapter 5: Physical Design and Quality of Life in Senior Housing
- Design and the Environment
- Adaptations of the Physical Environment
- Chapter 6: Building a Positive Social Environment in Senior Housing
- Dimensions of the Social Environment
- Social Environment in Senior Housing
- Social World of Elderly Tenants
- Socially Isolated Tenants
- Fostering a Positive Social Climate in Senior Housing
- What Housing Managers can do to Influence the Social Environment
- Chapter 7: Social Support in the Lives of Elderly Tenants
- What is Social Support?
- How do Elderly Tenants Receive Support?
- Is all Assistance that Elderly Tenants Receive Beneficial?
- Who are Vulnerable or “at Risk” Elderly Tenants?
- What Happens to Social Networks with Aging?
- Informal Support from Family, Friends, and Neighbors
- Formal Supportive Services
- Quasi-Formal Support
- New Roles for Housing Managers and Social Service Providers
- Chapter 8: Formal Services in Senior Housing
- Formal Services
- Nature of the Formal Service System Serving Elderly Tenants
- Necessary Skills for Housing Managers and Social Service Providers
- Formal Services for Elderly Tenants with Disabilities
- Chapter 9: Special Mental Health Issues in Senior Housing
- Alcoholism and Substance Abuse
- Alcohol use in Senior Housing and Retirement Communities
- Cognitive Impairment among Elderly Tenants
- Depression among Elderly Tenants
- Referral for Mental Health Problems
- Other Mental Health Concerns Facing Housing Managers
- Chapter 10: Working with Special Populations in Senior Housing
- The Legal Rights of Handicapped Persons and Integration into Senior Housing
- Housing Managers' Fear and Uncertainty about Fair Housing
- Persons with Developmental Disabilities
- Perspectives on Elderly and Developmentally Disabled Persons
- Psychiatric Disorders
- Community Mental Health Centers
- Issues for Housing Managers Dealing with Persons with Chronic Mental Health Disorders
- Misconceptions about Mental Illness
- Senior Housing Tenants' Attitudes
- Chapter 11: Housing Managers, Social Service Providers, and Health Care Professionals Working Together
- The Importance of Alliances among Housing, Social Service, and Health Care Professionals
- Social Support and Social Network Theory: A Theoretical Perspective on Partnerships
- Barriers to Alliances or Partnerships
- Types of Partnerships Serving Vulnerable Elderly Tenants
- Basic Elements for Successful Alliances Collaboration
To my children, Kate, Liz, and Sarah, whose love makes our house a home
Copyright ©1992 by Sage Publications, Inc.
All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher.
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Library of Congress Cataloging-in-Publication Data
Sheehan, Nancy W.
Successful administration of senior housing: working with elderly residents / Nancy W. Sheehan.
Includes bibliographical references (p.) and index.
ISBN 0-8039-4524-8. — ISBN 0-8039-4525-6 (pbk.)
1. Old age homes—United States—Management. 2. Aged—Housing—United States—Management. 3. Social work with the aged.—United States. 4. Aged—Home care—United States—Management. I. Title.
92 93 94 95 10 9 8 7 6 5 4 3 2 1
Sage Production Editor: Diane S. Foster
Considering that at least 2.5 million Americans live in housing explicitly planned for and occupied by people over age 60 or so, it is astonishing that this century of population aging has had to wait 92 years for the appearance of Dr. Sheehan's book. A less hyperbolic statement would date the high perceived salience of housing for older people from about 1959, but the years since that time have seen extraordinary concern for many facets of planned housing. National, state, and local levels, the governmental, nonprofit, and for-profit sectors, policy specialists, planners, designers, and researchers are some of the interest groups that have given major attention to this form of service for the elderly population. Service planners and deliverers have also recognized housing as an essential component of the total community service system.
For some reason, however, housing as real estate (number of units), housing as a physical entity (designing for human needs), housing as a haven (physical security), and other images have dominated our concerns. Relatively absent has been the concept of housing as “care management,” a term used by James Sykes and elaborated as the overriding topic of Dr. Sheehan's book. Although many of us who have been active in supporting the growth of quality housing programs have bemoaned the neglect of housing administration as a developing profession, few attempts to fill the gap have appeared. One must, of course, acknowledge some [Page x]concrete efforts that have been made to upgrade the quality of housing management through training programs. The American Association of Homes for the Aged has led the way for many years in providing seminars, instructional material, and certification guidelines for nonprofit management. The Real Estate Institute has shown some similar interest, and the National Center for Housing Management has valiantly attempted to provide training for people already engaged in management, but less rich in the care aspects of management.
The absence of a source such as the present book may well have been a major factor in limiting the development of care management to a level equal to that of fiscal and administrative management. Very literally this is the first book ever written that attempts to apply the large body of knowledge in gerontology to the task of person-oriented housing administration. Compare this lack to the long list of books on housing policy and housing planning or design that has appeared over the past few decades. One of the problems is the contrast between the glitter of the physical housing and the intangibility of management. Few housing administrators have become heroes. It seems very likely, however, that Dr. Sheehan's book will have a hand in creating some such heroes.
The reader will find the book informed by the last word in gerontological theory and research, integrated so successfully that one is aware primarily of the good sense displayed in the discussion of each of her topics. A real strength is her willingness to acknowledge the complexity of the issues she discusses. No person will experience a sense of unreality as he or she compares real management issues with the thoughtful suggestions advanced here. Effective administrative skills will become enhanced through the feelings of confidence engendered by Dr. Sheehan's acknowledgment of common problems and by the concrete suggestions offered for handling them.
In particular, there are many areas in which positive control may be exercised by the administrator. Decisions regarding occupancy, orienting new tenants, monitoring the match between tenant need and what the housing can provide, fostering positive social attitudes and behaviors, enriching on-site housing programs, adapting the physical environment to individual needs, [Page xi]and relating the housing context to the external community of neighbors, family, and formal services are only a few of the topics discussed. Despite the clear suggestions made for applying knowledge to such problems, the overall philosophy of respect for tenant autonomy comes through at every step. The housing manager is ideally an effective partner of the tenant, not the expert who always knows best.
Although many of these topics have been discussed in scattered literature, one section of her book provides material that is brand new and timely. As an expert in mental health and developmental disability, Dr. Sheehan has something new to say about dealing with the mental health of older tenants. Alcohol abuse, mental illness, mental retardation, and physical handicap, as well as possible age integration, are realities of the present-day housing scene. The Section 504 legislation of access and other more recent regulations specify the right of people with all types of disability to be accommodated in publicly assisted housing. The suggestion as to how management can deal with these admittedly difficult problems are fortified by first-hand knowledge of local programs that have successfully coped with integration of disabled and “mainstream” elders.
A last thought is the hope that enhanced management expertise can help us survive what are surely the darkest days yet seen in the history of housing for the elders. The United States has endured a full decade of famine in planned housing for any but the most economically privileged elders. Every program except the Section 202 program has either stopped completely (e.g., new public housing construction) or has been pure political tokenism (e.g., the Congregate Housing Services Program or the Congregate Voucher Program). Existing housing is being starved in maintenance, rehabilitation, and service-support funding, despite the clear evidence that the aging-in-place population is straining the limits of such environments to meet its needs. A crisis of need and demand is certain to come in the last decade of the twentieth century.
The lack of national economic resources is the obvious excuse given for such neglect. It will probably be several more years before the crisis deepens enough and political ideology moves [Page xii]enough to enable the nation to accept a realistic level of taxation and public-private partnership to reverse the neglect. In the meantime, creative, effective housing management may be our only hope. The silver lining of the housing neglect of the 1980s may be that there will finally be motivation to utilize management resources to their fullest potential. Creating good management out of hunger is a bad rationale for it, but if creative management achieves its momentum during a period of starvation, it should flourish extraordinarily well when housing resources in general improve.Philadelphia Geriatric Center
I am indebted to so many people who provided inspiration, help, and encouragement as I have pursued my interest in senior housing.
The Applied Fellowship Program of the Gerontological Society of America and the Connecticut Department on Aging provided funding for my initial experience doing research in senior housing. From this early experience, I am particularly indebted to Kevin Mahoney, Ph.D., for his guidance and support in helping me learn about applied research. I am also indebted to the many elderly tenants in public senior housing who openly shared their experiences concerning living in senior housing.
Other research endeavors examining facets of planned housing environments have been made possible with the support and cooperation of housing agencies throughout the state. The Connecticut Department of Housing, Connecticut Housing Finance Agency, and local housing authorities have provided consistent support and encouragement in facilitating research examining senior housing. Among the individuals who have made these partnerships possible are Michael Duffy and Richard LoPresti, Connecticut Department of Housing, Ralph Cheyney and Bette Meyerson, Connecticut Housing Finance Agency, and Horace McCaulley, Connecticut Department on Aging.
In addition, the Administration on Aging, U.S. Department of Health and Human Services, has provided funding to carry out [Page xiv]several model projects addressing the needs of older persons in senior housing. Both the Elderly Renters Project (90AT042501) and the Elderly Supportive Services Program (90AM043901) have provided the opportunity to work with many dedicated people working the fields of both aging and elderly housing. I am deeply indebted to the many people who have shared their knowledge, expertise, and skills in working with tenants in senior housing. The idea for this book grew out of the experiences of the Elderly Renters Project designed to train housing managers and social services providers to work with elderly tenants. This book is an attempt to address the complex issues that housing managers and social service providers identified growing out of their work with elderly tenants.
Finally, without the help and technical assistance of my husband, Alfred Tufano, I would never have been able to complete this project. His tireless help in editing versions of the manuscript has provided the essential support and encouragement that I needed.
Appendix A: Assessment of Independent Living Skills[Page 199][Page 201]Assessment of Independent Living Skills[Page 202][Page 203][Page 204]
Appendix B: Computerized Case Management Assessment[Page 205][Page 206]Example of Computerized Wellness Profile Functional Assessment
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