Kara Bauer

Date of Award

January 2022

Document Type


Degree Name

Doctor of Philosophy (PhD)


Counseling Psychology & Community Services

First Advisor

Kara Wettersten


Nursing Home Decision Satisfaction for family caregivers who have made nursing home decisions with and on behalf of older adults was examined through Self Determination Theory. Participants (n = 297) completed the study via Amazon Mechanical Turk during March 2021. Structural equation modeling was used to assess relationships between Autonomy Support, Multicultural Inclusiveness, Perceived Competence, COVID-19, and Nursing Home Decision Satisfaction. Specifically, the relationship between the exogenous variable of Autonomy Support and the endogenous variable of Nursing Home Decision Satisfaction was partially mediated by Perceived Competence and demonstrated acceptable fit. Results suggest that Self Determination Theory is a compelling and useful framework for assessing Nursing Home Decision Satisfaction for family caregivers of older adults. Although not included in the final partially mediated model, Multicultural Inclusiveness was significantly and directly associated with Perceived Competence. This suggests that though Multicultural Inclusiveness may be an important component of Relatedness within Self Determination Theory, the assessment of this important factor is underdeveloped. Satisfaction with COVID-19 Safety Measures, Communication and Decision after COVID-19 were also significantly associated with Autonomy Support and Multicultural Inclusiveness. Implications for nursing homes indicate the importance of fostering autonomy support for family caregivers as findings in this study indicated it significantly contributed to nursing home decision satisfaction. Keywords: family caregivers, older adults, nursing homes, self-determination theory