Perceived Decisional Control as a Mediator between Moving to Assisted Living Due to Caregiver Burden and Relocation Adjustment.

Objectives: The rapid growth of the older population in the United States has led to increased utilization of assisted living facilities (ALFs), and it is important to understand what factors may facilitate better adjustment. This study examined the mediating role of perceived decisional control in the relationship between moving to assisted living (AL) to prevent/alleviate caregiver burden and post-relocation adjustment. Methods: Participants were 91 newly-transitioned residents of ALFs in Alabama and Maryland. Data were gathered through in-person interviews and questionnaires. Mediation analyses were done using the PROCESS macro for SPSS, applying 5,000 bootstrap resamples with 95% bias-corrected confidence intervals estimated around the indirect effect. Results: The effect of moving to AL to prevent/alleviate caregiver burden on post-relocation depression and socialization was indirect and dependent on the degree of perceived decisional control. Conclusions: Perceived decisional control may be a key factor in adjusting to AL, even when the move is catalyzed by such a complex and emotionally laden construct as caregiver burden. Clinical Implications: Greater perceived decisional control over potential relocation may facilitate better adjustment, and other parties involved in the decision-making process should strive to involve the older adult in question in this process to the greatest extent possible.