Off-campus UMass Amherst users: To download campus access dissertations, please use the following link to log into our proxy server with your UMass Amherst user name and password.

Non-UMass Amherst users: Please talk to your librarian about requesting this dissertation through interlibrary loan.

Dissertations that have an embargo placed on them will not be available to anyone until the embargo expires.

Author ORCID Identifier



Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program


Year Degree Awarded


Month Degree Awarded


First Advisor

Cynthia Jacelon

Second Advisor

Jeungok Choi

Third Advisor

Rebecca Ready

Subject Categories

Geriatric Nursing | Nursing


Home is the desired site of care for most adults in the US (Eckert, Morgan & Swamy, 2004). The number of older adults who potentially require supportive care at home is rapidly growing. Our current healthcare infrastructure must evolve to accommodate the preference for homecare. This investigation will provide quantitative testing of a qualitatively-derived model called Maintaining the Balance (MTB) developed by Jacelon (2010). MTB describes the factors that drive a community-dwelling older adult’s ability to achieve OW in the home environment. Secondary analysis of data collected for the National Social Life, Health, and Aging Project (NSHAP) was utilized. Path analysis technique was employed to explore the effect of the 5 balance variables: health, activity, autonomy, attitude, and relationships on the outcome variable of OW. Attitude was the variable with the largest effect on OW. Activity, health, and relationships also had significant effects on OW. Autonomy and age were non-significant factors. The hypothesized model was partially supported by the NSHAP dataset.