Using ecological frameworks to advance a field of research, practice, and policy on aging-in-place initiatives

Abstract

Initiatives to promote aging in place have emerged rapidly in the United States across various health care settings (e.g., acute care hospitals, skilled nursing facilities) and broader community settings (e.g., public social service agencies). Moreover, recent federal policies include a growing number of provisions for local efforts to promote aging in place. Despite emerging bodies of research that have described singular initiatives in their own right, there has been very little scholarship that forges conceptual linkages across this increasingly vast domain of research, practice, and policy. Integrative theory development is critical to ensure that aging-in-place initiatives do not become fragmented from each other. This article uses insights from ecological frameworks-specifically Urie Bronfenbrenner's bioecological systems theory and M. Powell Lawton's general ecological model of aging-to conceptualize a range of programs as aging-in-place initiatives and for describing their similarities and differences, particularly in terms of the features through which they intend to promote aging in place. Theoretically derived dimensions along which to characterize aging-in-place initiatives include environment-focused aspects (e.g., the types of social systems and structures that the initiatives target for change) and person-focused aspects (e.g., the extent to which the initiatives target particular subgroups of older adults). The article concludes with a discussion on how these theoretically derived dimensions can be used to advance and integrate research, practice, and policy to systematically develop and expand aging-in-place initiatives.