Center for Excellence in Assisted Living CEAL@UNC

Advancing the well-being of the people who live and work in assisted living through research, practice, and policy.

Geriatric Nursing

Analysis of Exercise Programs in Assisted Living Facilities – A Cross-Sectional Study

Nov 1, 2025
This descriptive study examined exercise programs in 12 AL communities using data form 216 residents. Overall, 55% of participants used assistive devices, but only 17% had their devices assessed by a healthcare professional within the last 12 months; all facilities offered seated exercises, and four also included standing exercises. Exercise programs focused on a range of motion, some combined with resistance or functional training, but there was a predominance of low-intensity regimens. The findings indicated a need for better training for activity directors in moderate and high intensity exercises, and need for engaging more of a community's residents in physical activity.

Analysis of Exercise Programs in Assisted Living Facilities – A Cross-Sectional Study

by Lea Efird-Green

This descriptive study examined exercise programs in 12 AL communities using data form 216 residents. Overall, 55% of participants used assistive devices, but only 17% had their devices assessed by a healthcare professional within the last 12 months; all facilities offered seated exercises, and four also included standing exercises. Exercise programs focused on a range of motion, some combined with resistance or functional training, but there was a predominance of low-intensity regimens. The findings indicated a need for better training for activity directors in moderate and high intensity exercises, and need for engaging more of a community’s residents in physical activity.

Denture Care in Assisted Living: Best Practices and Clinical Importance for Resident Health

Sep 1, 2025
This editorial discusses the implications of denture management in long-term care settings, focusing on barriers to consistent removal, the risks of continuous wear, and the nutritional consequences of poor denture fit. Strategies focusing on infection prevention, adequate nutrition, integrating tasks into routine workflows, and engaging both staff and families are presented to improve denture care.

Denture Care in Assisted Living: Best Practices and Clinical Importance for Resident Health

by Lea Efird-Green

This editorial discusses the implications of denture management in long-term care settings, focusing on barriers to consistent removal, the risks of continuous wear, and the nutritional consequences of poor denture fit. Strategies focusing on infection prevention, adequate nutrition, integrating tasks into routine workflows, and engaging both staff and families are presented to improve denture care.

The Role of Aesthetics in Promoting Health-Related Quality of Life for Older Adults Transitioning to Long-Term Services and Support

Sep 1, 2025
This study investigated the relationship between the sense of aesthetics in the physical structure of a long-term care community and quality of life for 376 older adults recently enrolled in long-term services and supports. Increased social interaction and religious participation were positively associated with a sense of aesthetics, as was being in AL rather than nursing homes.

The Role of Aesthetics in Promoting Health-Related Quality of Life for Older Adults Transitioning to Long-Term Services and Support

by Lea Efird-Green

This study investigated the relationship between the sense of aesthetics in the physical structure of a long-term care community and quality of life for 376 older adults recently enrolled in long-term services and supports. Increased social interaction and religious participation were positively associated with a sense of aesthetics, as was being in AL rather than nursing homes.

Ensuring Safety in Assisted Living Facilities: A Comprehensive Risk Management Program

Jul 1, 2025
This editorial outlines a risk management program for AL communities based on the 5 Rs: Recognize, Rank, Respond, Report, and Review. It outlines that for successful risk management a community must first recognize potential risks, then rank them based on likelihood and impact, then respond appropriately while reporting the status of the risks, and finally regularly review risk management processes.

Ensuring Safety in Assisted Living Facilities: A Comprehensive Risk Management Program

by Lea Efird-Green

This editorial outlines a risk management program for AL communities based on the 5 Rs: Recognize, Rank, Respond, Report, and Review. It outlines that for successful risk management a community must first recognize potential risks, then rank them based on likelihood and impact, then respond appropriately while reporting the status of the risks, and finally regularly review risk management processes.

Artificial Intelligence in Assisted Living and Memory Care: Enhancing Care or Increasing Exposure?

May 1, 2025
WHAT THIS MEANS FOR YOU: This editorial uses data from the CAN Aging Servces Claim Report to examine how artificial intelligence (AI) can alter care, liability, and decision-making in assisted living and memory care settings.

Artificial Intelligence in Assisted Living and Memory Care: Enhancing Care or Increasing Exposure?

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This editorial uses data from the CAN Aging Servces Claim Report to examine how artificial intelligence (AI) can alter care, liability, and decision-making in assisted living and memory care settings.

The Importance of Nature and Wishes for Nature-Based Experiences Among Older Adults in Assisted Living Facilities

May 1, 2025
WHAT THIS MEANS FOR YOU: This cross-sectional study of 25 assisted living communities in Finland examined 854 residents' views of nature-based interventions. Only 24% of residents could move outdoors independently, and only 51% had the amount of nature exposure they wanted, although 96% consider nature important and 83% stated interest in nature-based interventions. Results indicate developing nature-based interventions could be appealing for older adults.

The Importance of Nature and Wishes for Nature-Based Experiences Among Older Adults in Assisted Living Facilities

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This cross-sectional study of 25 assisted living communities in Finland examined 854 residents’ views of nature-based interventions. Only 24% of residents could move outdoors independently, and only 51% had the amount of nature exposure they wanted, although 96% consider nature important and 83% stated interest in nature-based interventions. Results indicate developing nature-based interventions could be appealing for older adults.

Keeping Assisted Living Communities Secure: A Comprehensive Approach from the Perimeter to the Interior

Mar 1, 2025
WHAT THIS MEANS FOR YOU: This article highlights the importance of physical and cybersecurity in assisted living using the People, Programs, Training, and Technology (P2T2) system. For the system to be effective, staff training, resident education, and collaboration with law enforcement are integral. Best practices like checklists can be implemented so that physical security, technological solutions, and emergency preparedness can be addressed for quality assurance.

Keeping Assisted Living Communities Secure: A Comprehensive Approach from the Perimeter to the Interior

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This article highlights the importance of physical and cybersecurity in assisted living using the People, Programs, Training, and Technology (P2T2) system. For the system to be effective, staff training, resident education, and collaboration with law enforcement are integral. Best practices like checklists can be implemented so that physical security, technological solutions, and emergency preparedness can be addressed for quality assurance.

Understanding Urinary Incontinence and Urinary Tract Infections as Key Contributors to Falls in Assisted Living and Memory Care Communities

Jan 1, 2025
WHAT THIS MEANS FOR YOU: This editorial examined how urinary incontinence (UI) and urinary tract infections (UTIs) are contributors to falls for assisted living and memory care residents. Impacts on balance, stability, confusion, and fatigue all contribute to the increased risk. Future falls prevention approaches should consider UI and UTIs, structured toileting, and caregiver training to reduce risk.

Understanding Urinary Incontinence and Urinary Tract Infections as Key Contributors to Falls in Assisted Living and Memory Care Communities

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This editorial examined how urinary incontinence (UI) and urinary tract infections (UTIs) are contributors to falls for assisted living and memory care residents. Impacts on balance, stability, confusion, and fatigue all contribute to the increased risk. Future falls prevention approaches should consider UI and UTIs, structured toileting, and caregiver training to reduce risk.

Know the Resident: Unlocking Value and Positive Outcomes in Assisted Living Nursing

May 1, 2024
WHAT THIS MEANS FOR YOU: In this editorial, the authors emphasize that addressing social determinants of health in AL communities is crucial for improving residents' well-being and can be accomplished in part through nurse leadership. It presents a framework to address residents’ social needs, focusing on a proactive and holistic approach to care.

Know the Resident: Unlocking Value and Positive Outcomes in Assisted Living Nursing

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: In this editorial, the authors emphasize that addressing social determinants of health in AL communities is crucial for improving residents’ well-being and can be accomplished in part through nurse leadership. It presents a framework to address residents’ social needs, focusing on a proactive and holistic approach to care.

Effect of Immersive Virtual Reality Reminiscence versus Traditional Reminiscence Therapy on Cognitive Function and Psychological Well-being among Older Adults in Assisted Living Facilities: A Randomized Controlled Trial

Nov 1, 2023
WHAT THIS MEANS FOR YOU: A study of 60 assisted living residents observed the effects of virtual reality reminiscence and traditional reminiscence therapy on residents’ cognitive function and psychological wellbeing. Compared to a control group, there was a statistically significant increase in cognition and psychological wellbeing in both the reminiscence groups.

Effect of Immersive Virtual Reality Reminiscence versus Traditional Reminiscence Therapy on Cognitive Function and Psychological Well-being among Older Adults in Assisted Living Facilities: A Randomized Controlled Trial

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: A study of 60 assisted living residents observed the effects of virtual reality reminiscence and traditional reminiscence therapy on residents’ cognitive function and psychological wellbeing. Compared to a control group, there was a statistically significant increase in cognition and psychological wellbeing in both the reminiscence groups.

The Complexity of Providing Behavioral Healthcare in Assisted Living

Oct 1, 2023
WHAT THIS MEANS FOR YOU: This editorial discussed the difficulty providing mental and behavioral healthcare in assisted living. Increasing numbers of residents experience high rates of behavioral health issues, but only 40% of communities offer treatment for these issues, despite the fact that lack of treatment is associated with negative outcomes such as severe depression and suicidal ideation. To improve behavioral healthcare in assisted living, adequate staffing and staff education is required, as well as insurance reimbursements for mental health services at similar levels to those for medical care.

The Complexity of Providing Behavioral Healthcare in Assisted Living

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This editorial discussed the difficulty providing mental and behavioral healthcare in assisted living. Increasing numbers of residents experience high rates of behavioral health issues, but only 40% of communities offer treatment for these issues, despite the fact that lack of treatment is associated with negative outcomes such as severe depression and suicidal ideation. To improve behavioral healthcare in assisted living, adequate staffing and staff education is required, as well as insurance reimbursements for mental health services at similar levels to those for medical care.

Storage Issues in Assisted Living Facilities and Senior Living Communities

Feb 1, 2022
WHAT THIS MEANS FOR YOU: During the COVID-19 pandemic, AL communities faced hurdles obtaining vital supplies including masks and gloves; AL communities were often considered lower priority than other healthcare settings, leading to delays in receipt. When supplies were obtained, the quantity often overwhelmed available storage space, leading to unsafe supply storage. Solutions include improved emergency management, emphasizing proper storage, and optimizing delivery schedules.

Storage Issues in Assisted Living Facilities and Senior Living Communities

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: During the COVID-19 pandemic, AL communities faced hurdles obtaining vital supplies including masks and gloves; AL communities were often considered lower priority than other healthcare settings, leading to delays in receipt. When supplies were obtained, the quantity often overwhelmed available storage space, leading to unsafe supply storage. Solutions include improved emergency management, emphasizing proper storage, and optimizing delivery schedules.