Journals of Gerontology Series B: Psychological Sciences and Social Sciences, Vol 54, Issue 6 S349-S355, Copyright © 1999 by The Gerontological Society of America
Correlates of open- and locked-facility placement in a population of decisionally impaired adults
SL Reynolds and KH Wilber
Department of Gerontology, University of South Florida, USA. sreynold@chumal.cas.usf.edu
OBJECTIVES: This study compares characteristics of public conservatees
placed in locked facilities with those in less restrictive settings. Given
the principle of the least restrictive alternative, the study seeks to
identify factors, including the role of aging and advanced age, associated
with restrictive placement within conservatorship. METHODS: Management
Information Systems data on 1,534 adult conservatees in Los Angeles County
in July, 1993, are examined in cross- section. Models exploring individual
and environmental characteristics of conservatees and linear, curvilinear,
and multiplicative aging effects are tested on the probability that adults
are placed in locked facilities versus all other placement types. RESULTS:
Locked facility placement is associated with being female, receiving SSI, a
diagnosis of dementia, and being identified as a danger to oneself and to
others. Locked-facility placement is associated with increasing age until
age 60, when the effect becomes inversely related; the multiplicative
effect of older age and impaired functioning is also inversely related.
DISCUSSION: The curvilinear nature of age and the interaction effect of Age
x Functioning implies that increasing frailty in older adults makes locked
facility-placement less likely. Further research is needed on whether
alternative placement types, such as special care units with secured
perimeters, can further reduce the need for locked facilities.
