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.

JAMA Internal Medicine

Social Participation Among Older Adults Before and After Long-Term Care Facility Entry

Oct 1, 2025
This study investigated factors related to social participation before and after entry into long-term care (LTC) using data from 606 LTC community entrants in the National Health and Aging Trends Study from 2011 to 2019. Social participation decreased before entry into LTC; after entry, social outings continued to decrease, however club and religious participation increased, with women and those in AL communities more likely to maintain social participation.

Social Participation Among Older Adults Before and After Long-Term Care Facility Entry

by Lea Efird-Green

This study investigated factors related to social participation before and after entry into long-term care (LTC) using data from 606 LTC community entrants in the National Health and Aging Trends Study from 2011 to 2019. Social participation decreased before entry into LTC; after entry, social outings continued to decrease, however club and religious participation increased, with women and those in AL communities more likely to maintain social participation.

State Variation in Potentially Burdensome Transitions among Assisted Living Residents at the End of Life

Feb 1, 2022
WHAT THIS MEANS FOR YOU: There are significant differences in the quality of end-of-life care in AL. Research on 37,668 deceased Medicare beneficiaries who lived in AL found that 1 in 5 experienced challenging transitions including frequent hospitalizations before their death. Burdensome transitions, especially in the last three days of life, varied widely among states, which may be associated with state-level regulations.

State Variation in Potentially Burdensome Transitions among Assisted Living Residents at the End of Life

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: There are significant differences in the quality of end-of-life care in AL. Research on 37,668 deceased Medicare beneficiaries who lived in AL found that 1 in 5 experienced challenging transitions including frequent hospitalizations before their death. Burdensome transitions, especially in the last three days of life, varied widely among states, which may be associated with state-level regulations.