Correlates of open- and locked-facility placement in a population of decisionally impaired adults

Objectives. This study compares characteristics of public conservatees plac ed 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 res trictive placement within conservatorship. Methods, Management Information Systems data on 1,534 adult conservatees in Los Angeles County in Jury, 1993, are examined in cross-section. Models ex ploring individual and environmental characteristics of conservatees and li near, curvilinear, and multiplicative aging effects are tested on the proba bility that adults are placed in locked facilities versus all other placeme nt types. Results. Locked facility placement is associated with being female, receivi ng SSI, a diagnosis of dementia, and being identified as a danger to onesel f and to others. Locked-facility placement is associated with increasing ag e until age 60, when the effect becomes inversely related; the multiplicati ve 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 lacked facility-placement less likely. Further research is needed on whether alte rnative placement types, such as special care units with secured perimeters , can further reduce the need for locked facilities.