There has been a recent shift in the focus of quality of care indicators used to evaluate the nursing home environment from process to outcome measures. Life satisfaction is an indicator of well-being which is useful as an outcome measure of quality of care because of its linkage to health. Perceived social support has also demonstrated a relationship to life satisfaction. As a breakdown within the social support system is frequently the impetus for institutionalization in the elderly, perceived social support within the nursing home environment takes on added significance in its relationship to life satisfaction in the elderly nursing home resident. The major question examined was: How are perceived social environmental factors and perceived functional health status related to life satisfaction in elderly nursing home residents.

A social-ecological framework was used in this descriptive, correlational study. One hundred and fifteen elderly residents of three metropolitan nursing homes were interviewed. Using Pearson's correlation the social environmental variables of independence and cohesion along with functional health demonstrated significant and positive relationships to life satisfaction (p $<$.05).

Because of the intercorrelation among the variables, regression analysis was performed and revealed that the social-environmental variables of cohesion, independence, resident influence, and organization along with the variable functional health status accounted for 24% of the variance in life satisfaction (p $<$.05). Although scores on the resident influence scale were quite low, life satisfaction scores remained high. Cohesion scores' which reflect the residents' perception of support from their caretakers and from their peers were also very high. These findings may indicate that a bonding develops between the institutionalized elderly and their caregivers which precludes the drive for self-determination and fosters positive and protective feelings towards the caregiver.