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Autonomy, Identity, and Design in the COVID-19 Era

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(Re)designing the Continuum of Care for Older Adults

Abstract

This chapter examines the state of response and likely long-term implications across the continuum of place types for older adults, from independent housing to skilled nursing, with a focus on how physical settings and technological systems can empower autonomy and identity. It does so by adopting a person-environment (P-E) exchange framework as articulated by Chaudhury and Oswald (J Aging Stud 51:100821, 2019) This framework is structured in three sections: components of P-E interaction, P-E processes, and environment-related outcomes. Components of P-E interaction include individual characteristics, social factors, physical/built environments, and technological systems with this chapter focusing on the last two. These components form a milieu within which the dialectic interaction between agency and belonging occurs and ultimately informs assessments regarding autonomy and identity. Emergent themes discussed in this chapter include a heightened emphasis on inclusive housing models, age-friendly integration of technology, environmental flexibility in design and programming, and enhanced support for the needs of caregivers. Examining place change through an integrative P-E framework offers a lens to understanding what implications to agency and belonging might be tied to modifications in the physical and technological environment in response to COVID-19 and how that might inform outcomes related to autonomy and identity among older adults. The environmental responses to COVID-19 will accelerate the ability of independent housing to serve individuals longer in their homes and should promote a radical embrace of small house approaches to skilled care, thereby challenging assisted living as a place type altogether.

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Greer, V., Moore, K.D. (2023). Autonomy, Identity, and Design in the COVID-19 Era. In: Ferdous, F., Roberts, E. (eds) (Re)designing the Continuum of Care for Older Adults. Springer, Cham. https://doi.org/10.1007/978-3-031-20970-3_14

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