{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:35:00Z","timestamp":1791815700515,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000957","name":"Alzheimer's Association","doi-asserted-by":"publisher","award":["ARCOM\u201022\u2010882300"],"award-info":[{"award-number":["ARCOM\u201022\u2010882300"]}],"id":[{"id":"10.13039\/100000957","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23HL163402"],"award-info":[{"award-number":["K23HL163402"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K24HL143289"],"award-info":[{"award-number":["K24HL143289"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Promoting options for aging in place (AIP) has broad appeal to policymakers and professionals providing services to persons living with dementia (PWD). However, the benefits or burdens of AIP likely vary among individuals and families. We sought to describe factors influencing decision\u2010making to age in place versus seek a higher level of residential care for PWD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative study was undertaken as part of a larger mixed\u2010methods study utilizing semi\u2010structured interviews with PWD, family care partners, and dementia clinicians. Interview transcripts were analyzed using qualitative content analysis with constant comparison. Sample size was determined by thematic saturation within subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We conducted 74 interviews among 14 PWD, 36 care partners, and 24 clinicians. Preferences for AIP were driven by (1) desire to preserve independence, (2) a sense that the \u201cbest care\u201d is delivered by loved ones and in a familiar environment, (3) distrust and fear of care facilities, and (4) caregiver guilt. PWD and care partners frequently considered moving from home as a \u201clast resort\u201d and wanted to avoid planning for future care needs. Many decisions to move were reactive and triggered by patient safety events, physical dependency, or the loss of caregiver. Proactive decision\u2010making was facilitated by (1) prior experience witnessing the challenges of caring for a person with advanced dementia in the home; and (2) having substantial financial resources such that participants could seek major home adaptations or avoid \u201clower quality\u201d institutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Decisions regarding care setting for PWD frequently do not feel like a choice and are made under imperfect conditions. Programs using AIP as an outcome measure should recognize the various patient\u2010centered and non\u2010patient\u2010centered factors that influence such choices, and interventions should be designed to promote more informed and equitable decision\u2010making for care setting in dementia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19140","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T21:54:13Z","timestamp":1723672453000},"page":"3398-3412","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["\u201cWhat choice do we have?\u201d Reactive and proactive decision\u2010making for aging in place with dementia"],"prefix":"10.1111","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4803-0375","authenticated-orcid":false,"given":"Catherine L.","family":"Auriemma","sequence":"first","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Perelman School of Medicine University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maayra I.","family":"Butt","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"McMillan","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine A.","family":"Silvestri","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0844-7951","authenticated-orcid":false,"given":"Carolyn","family":"Chow","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Bahti","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Klaiman","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Harkins","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Karlawish","sequence":"additional","affiliation":[{"name":"Penn Memory Center University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Division of Geriatrics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Halpern","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Perelman School of Medicine University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Biostatistics, Epidemiology, and Biostatistics University of Pennsylvania in Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmp1607206"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/08959420801977574"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3928\/19404921\u201020110802\u201001"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","unstructured":"BinetteJ VasoldK.Home and community preferences: a national survey of adults age 18\u2010plus.2018. 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