Institutional attention and the disablement process: how safety governance shapes functional trajectories in later life.
The disablement process model identifies institutional environments as modifiers of the pathway from pathology to disability, yet has not specified the mechanisms through which they accelerate or interrupt disablement. This article proposes institutional attention ecology as a theoretical construct...
| Publicado en: | Gerontologist Vol. 66; no. 7; pp. 1 - 11 |
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| Formato: | Artículo |
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Oxford University Press / USA
Jul2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195281414&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195281414 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00169013 GET jtl: Gerontologist issn: 00169013 maglogo: N pubinfo: dt: Jul2026 vid: 66 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195281414 10.1093/geront/gnag076 ppf: 1 ppct: 10 formats: tig: atl: Institutional attention and the disablement process: how safety governance shapes functional trajectories in later life. aug: au: Sabharwal, Neha affil: Vintage Faire Nursing and Rehabilitation, Modesto, California, United States su: Corporate culture Responsibility Attention Nursing care facilities Patient-centered care Health facilities People with disabilities Activities of daily living Safety Disability determination Functional status Convalescence Accidental falls sug: subj: Corporate culture Responsibility Attention Nursing care facilities Patient-centered care Health facilities People with disabilities Activities of daily living All Other Outpatient Care Centers Nursing Care Facilities (Skilled Nursing Facilities) Community care facilities for the elderly Safety Disability determination Functional status Convalescence Accidental falls keyword: accountability aged aging copyrightHolder:The Gerontological Society of America copyrightYear:2026 disability ecology Functional decline https://dx.doi.org/10.1093/geront/gnag076 inLanguage:en internship and residency Long-term care medical residencies mobility publisher:Oxford University Press Quality measurement recovery of function relational autonomy safety sameAs:https://pubmed.ncbi.nlm.nih.gov/42057289/ skilled nursing facility accountability aged aging copyrightHolder:The Gerontological Society of America copyrightYear:2026 disability ecology Functional decline https://dx.doi.org/10.1093/geront/gnag076 inLanguage:en internship and residency Long-term care medical residencies mobility publisher:Oxford University Press Quality measurement recovery of function relational autonomy safety sameAs:https://pubmed.ncbi.nlm.nih.gov/42057289/ skilled nursing facility ab: The disablement process model identifies institutional environments as modifiers of the pathway from pathology to disability, yet has not specified the mechanisms through which they accelerate or interrupt disablement. This article proposes institutional attention ecology as a theoretical construct addressing this gap: the patterned distribution of organizational vigilance, investigation, and accountability across outcome domains within care institutions. In post-acute skilled nursing facilities, this ecology has become asymmetric, intensely organized around discrete safety events while leaving functional recovery largely outside institutional response. Drawing on the disablement process, relational autonomy theory, and qualitative evidence, we trace how this asymmetry reshapes functional trajectories and the conditions for authentic agency in later life. We propose attention ecology as a meso-level extension linking institutional context to resident-level outcomes. Nationally representative facility-level data (N = 13,713) support the predicted dissociation: safety performance and functional outcomes are essentially uncorrelated (Pearson r = 0.018). We advance 3 propositions: attention ecology operates as a formal extra-individual modifier in the disablement process; attention asymmetry produces structurally imposed dependency distinguishable from chosen dependency; and the disablement process in institutional settings is embedded in a moral ecology shaping which forms of diminishment are recognized as problems and which are normalized as aging. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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