A CONTEXTUAL APPROACH FOR UNDERSTANDING INDIVIDUAL AUTONOMY IN MANAGED COMMUNITY LONG-TERM-CARE

This article develops a framework for identifying community long-term care program and policy features that support or hinder client autonomy. After introducing the topic, the authors develop a contextual approach for understanding individual autonomy and discuss its relevance to community long-term care. They also illustrate how current financing, organization, and delivery of community long-term care provide clients with opportunities for meaningful choice. The authors summarize the implications that a contextual autonomy approach has for both community long-term care policy and program features and make specific policy recommendations.