The Dynamics of Social Networks and Health in an Assisted Living Facility

Social relationships are critical to the well-being and health of the approximately one million older Americans living in assisted living facilities (ALFs). However, some ALF residents experience loneliness and social isolation. Residents’ physical impairments, cognitive functioning, and level of depression may determine their trajectories of disability and influence their ability to form and maintain social ties. In spite of this, little is known about the dynamics of residents’ social networks and health. This dissertation examines these dynamics among residents of an ALF in Houston, TX using longitudinal social network analysis. It describes four types of social networks in the facility and provides insights into the structure and dynamics of residents’ social ties. In addition, it explores the co-evolution of residents’ disability-related health and social relationships. The study found that many residents engaged in social support, there was a robust acquaintance network and that many residents reported companionships with other residents. Negative interactions were reported by the majority of residents. The study did not find support for the hypothesized co-evolution of residents’ social networks and disability-related health nor evidence of social selection or influence in disability-related health over the course of three months. On the most fundamental level, this research suggests that ALFs themselves are an effective intervention to support the social integration of older adults who have lost some of their independence. Other practice implications concern residents’ emotional needs and negative interactions. Long-term care policies should consider social integration as a potential benefit of ALFs and seek ways to provide equitable access to care in ALFs.