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.

COVID-19

Primary Care Telemedicine Use among Assisted Living Residents with Dementia during COVID-19: Race and Dual Enrollment Status

May 1, 2023
In 2023-03-01 12:00:00 2020, restrictions on telemedicine were waived, allowing services to be delivered through video-conferencing or telephone.1,2 Telemedicine offered a way to stay connected with primary care providers during the COVID-19 pandemic,3 which may be particularly suitable for assisted living facility (AL) residents with dementia who have high care needs. Expansion, however, raised concerns […]

Primary Care Telemedicine Use among Assisted Living Residents with Dementia during COVID-19: Race and Dual Enrollment Status

by Lea Efird-Green

In 2023-03-01 12:00:00 2020, restrictions on telemedicine were waived, allowing services to be delivered through video-conferencing or telephone.1,2 Telemedicine offered a way to stay connected with primary care providers during the COVID-19 pandemic,3 which may be particularly suitable for assisted living facility (AL) residents with dementia who have high care needs. Expansion, however, raised concerns […]

Caregiver Involvement and Concerns with Care of Residents of Assisted Living Before and During the COVID-19 Pandemic

Apr 1, 2023
Introduction Family/friend caregivers play an essential role in promoting the physical and mental health of older adults in need of care – especially during the COVID-19 pandemic and especially in assisted living (AL) homes, were resident care needs are similarly complex as in long-term care homes but fewer staffing resources and services are available. However, […]

Caregiver Involvement and Concerns with Care of Residents of Assisted Living Before and During the COVID-19 Pandemic

by Lea Efird-Green

Introduction Family/friend caregivers play an essential role in promoting the physical and mental health of older adults in need of care – especially during the COVID-19 pandemic and especially in assisted living (AL) homes, were resident care needs are similarly complex as in long-term care homes but fewer staffing resources and services are available. However, […]

Digital Immunization Tracking in Long-Term Care and Assisted Living Facilities

Feb 1, 2023
A disproportionate share of the health impacts of COVID-19 has been borne by older adults, particularly those in long-term care facilities (LTCs). Vaccination has been critical to efforts to combat this issue, but as we begin to emerge from this pandemic, questions remain about how to protect the health of residents of LTC and assisted […]

Digital Immunization Tracking in Long-Term Care and Assisted Living Facilities

by Lea Efird-Green

A disproportionate share of the health impacts of COVID-19 has been borne by older adults, particularly those in long-term care facilities (LTCs). Vaccination has been critical to efforts to combat this issue, but as we begin to emerge from this pandemic, questions remain about how to protect the health of residents of LTC and assisted […]

Preparedness and Response of Assisted Living Facilities Toward COVID-19 Infection Control in Houston, Texas, USA

Feb 1, 2023
Background Long-term care facilities (LTCFs) including assisted living facilities (ALFs) are hubs for high transmission and poor prognosis of COVID-19 among the residents who are more susceptible due to old age and comorbidities. Aim Houston Health Department conducted assessments of ALFs within the City of Houston to determine preparedness and existing preventive measures at the […]

Preparedness and Response of Assisted Living Facilities Toward COVID-19 Infection Control in Houston, Texas, USA

by Lea Efird-Green

Background Long-term care facilities (LTCFs) including assisted living facilities (ALFs) are hubs for high transmission and poor prognosis of COVID-19 among the residents who are more susceptible due to old age and comorbidities. Aim Houston Health Department conducted assessments of ALFs within the City of Houston to determine preparedness and existing preventive measures at the […]

COVID-19 Resources

Jan 11, 2023
Please visit the following sites for resources and information on COVID-19.

COVID-19 Resources

by Lea Efird-Green

Please visit the following sites for resources and information on COVID-19.

Coping Behaviors and Health Status during the COVID-19 Pandemic among Caregivers of Assisted Living Residents in Western Canada

Dec 1, 2022
Objectives To examine the prevalence of coping behaviors during the first 2 waves of the COVID-19 pandemic among caregivers of assisted living residents and variation in these behaviors by caregiver gender and mental health. Design Cross-sectional and longitudinal survey. Setting and Participants Family/friend caregivers of assisted living residents in Alberta and British Columbia. Methods A […]

Coping Behaviors and Health Status during the COVID-19 Pandemic among Caregivers of Assisted Living Residents in Western Canada

by Lea Efird-Green

Objectives To examine the prevalence of coping behaviors during the first 2 waves of the COVID-19 pandemic among caregivers of assisted living residents and variation in these behaviors by caregiver gender and mental health. Design Cross-sectional and longitudinal survey. Setting and Participants Family/friend caregivers of assisted living residents in Alberta and British Columbia. Methods A […]

Excess Mortality Among Assisted Living Residents with Dementia during the COVID-19 Pandemic

Oct 1, 2022
Objective To evaluate whether assisted living (AL) residents with Alzheimer’s disease and related dementias (ADRD) experienced a greater rate of excess all-cause mortality during the first several months of the COVID-19 pandemic compared to residents without ADRD, and to compare excess all-cause mortality rates in memory care vs general AL among residents with ADRD. Design […]

Excess Mortality Among Assisted Living Residents with Dementia during the COVID-19 Pandemic

by Lea Efird-Green

Objective To evaluate whether assisted living (AL) residents with Alzheimer’s disease and related dementias (ADRD) experienced a greater rate of excess all-cause mortality during the first several months of the COVID-19 pandemic compared to residents without ADRD, and to compare excess all-cause mortality rates in memory care vs general AL among residents with ADRD. Design […]

Caregivers’ Concerns about Assisted Living Residents’ Mental Health during the COVID-19 Pandemic: A Cross-Sectional Survey Study

Sep 1, 2022
Family or friend caregivers’ concerns about assisted living (AL) residents’ mental health are reflective of poor resident and caregiver mental health. COVID-19-related visiting restrictions increased caregiver concerns, but research on these issues in AL is limited. Using web-based surveys with 673 caregivers of AL residents in Western Canada, we assessed the prevalence and correlates of […]

Caregivers’ Concerns about Assisted Living Residents’ Mental Health during the COVID-19 Pandemic: A Cross-Sectional Survey Study

by Lea Efird-Green

Family or friend caregivers’ concerns about assisted living (AL) residents’ mental health are reflective of poor resident and caregiver mental health. COVID-19-related visiting restrictions increased caregiver concerns, but research on these issues in AL is limited. Using web-based surveys with 673 caregivers of AL residents in Western Canada, we assessed the prevalence and correlates of […]

Prevalence and Correlates of Anxiety and Depression in Caregivers to Assisted Living Residents during COVID-19: A Cross-Sectional Study

Aug 1, 2022
Background Family and friend caregivers play significant roles in advocating for and ensuring quality health and social care of residents in Assisted Living (AL) homes. However, little is known about how the COVID-19 pandemic and related visitor restrictions affected their health and mental well-being. We examined the prevalence and correlates of anxiety and depressive symptoms […]

Prevalence and Correlates of Anxiety and Depression in Caregivers to Assisted Living Residents during COVID-19: A Cross-Sectional Study

by Lea Efird-Green

Background Family and friend caregivers play significant roles in advocating for and ensuring quality health and social care of residents in Assisted Living (AL) homes. However, little is known about how the COVID-19 pandemic and related visitor restrictions affected their health and mental well-being. We examined the prevalence and correlates of anxiety and depressive symptoms […]

Coronavirus Disease 2019 (COVID-19) in Assisted Living Communities: Neighborhood Deprivation and State Social Distancing Policies Matter

Aug 1, 2022
Background: Residents of long-term care facilities face significantly greater risk of contracting or dying from coronavirus disease 2019 (COVID-19). However, little is known about COVID-19 in assisted living communities (ALCs) and the potential determinants of its spread. We examined the association between COVID-19 cases in ALCs and the proportion of Medicare-Medicaid (dual) eligible minority residents, […]

Coronavirus Disease 2019 (COVID-19) in Assisted Living Communities: Neighborhood Deprivation and State Social Distancing Policies Matter

by Lea Efird-Green

Background: Residents of long-term care facilities face significantly greater risk of contracting or dying from coronavirus disease 2019 (COVID-19). However, little is known about COVID-19 in assisted living communities (ALCs) and the potential determinants of its spread. We examined the association between COVID-19 cases in ALCs and the proportion of Medicare-Medicaid (dual) eligible minority residents, […]

Dementia and COVID-19 Infection Control in Assisted Living in Seven States

Jun 1, 2022
Background Assisted living (AL) is the largest residential long-term care provider in the United States, including for persons with Alzheimer’s disease and related dementias. Despite recognizing the challenge of infection control for persons with dementia, this study of 119 AL communities is the first to describe dementia-relevant COVID-19 infection control across different types of AL […]

Dementia and COVID-19 Infection Control in Assisted Living in Seven States

by Lea Efird-Green

Background Assisted living (AL) is the largest residential long-term care provider in the United States, including for persons with Alzheimer’s disease and related dementias. Despite recognizing the challenge of infection control for persons with dementia, this study of 119 AL communities is the first to describe dementia-relevant COVID-19 infection control across different types of AL […]

The Impact of FFC-AL-EIT-D in Assisted Living during the COVID-19 Pandemic

Jun 1, 2022
The purpose of this study was to test the preliminary effectiveness and feasibility of implementation of Function Focused Care for Assisted Living Using the Evidence Integration Triangle in Assisted Living Communities with Residents with Dementia (FFC-AL-EIT-D) during the pandemic. This was a single group pre-post study design including 51 communities in a single state. The […]

The Impact of FFC-AL-EIT-D in Assisted Living during the COVID-19 Pandemic

by Lea Efird-Green

The purpose of this study was to test the preliminary effectiveness and feasibility of implementation of Function Focused Care for Assisted Living Using the Evidence Integration Triangle in Assisted Living Communities with Residents with Dementia (FFC-AL-EIT-D) during the pandemic. This was a single group pre-post study design including 51 communities in a single state. The […]

“We Weathered the Storm”: A Qualitative Phenomenological Study of the Lived Experience of Assisted Living Administrators during the COVID-19 Pandemic

May 1, 2022
The purpose of the current qualitative phenomenological study is to learn about the lived experiences of assisted living (AL) community administrators during the coronavirus disease 2019 (COVID-19) pandemic. Little is known about how administrators coped with the ever-changing mandates (e.g., visitation, testing, communal activities, acceptance of COVID-positive residents). Semi-structured interviews with AL administrators were conducted, […]

“We Weathered the Storm”: A Qualitative Phenomenological Study of the Lived Experience of Assisted Living Administrators during the COVID-19 Pandemic

by Lea Efird-Green

The purpose of the current qualitative phenomenological study is to learn about the lived experiences of assisted living (AL) community administrators during the coronavirus disease 2019 (COVID-19) pandemic. Little is known about how administrators coped with the ever-changing mandates (e.g., visitation, testing, communal activities, acceptance of COVID-positive residents). Semi-structured interviews with AL administrators were conducted, […]

Does Service Provider Matter during a Pandemic? COVID-19 Cases and Deaths among Nonprofit vs. For-Profit Assisted Living Facilities in Florida

Apr 1, 2022
When COVID-19 hit the U.S. in early 2020, individuals aged 65+ were identified as a higher risk population. In Florida, Governor DeSantis issued Emergency Order 20-006 to prohibit visitation to facilities housing groups of high-risk people, including assisted living facilities (ALFs). Regardless, 672 ALFs of the 3,019 in Florida had reported at least one positive […]

Does Service Provider Matter during a Pandemic? COVID-19 Cases and Deaths among Nonprofit vs. For-Profit Assisted Living Facilities in Florida

by Lea Efird-Green

When COVID-19 hit the U.S. in early 2020, individuals aged 65+ were identified as a higher risk population. In Florida, Governor DeSantis issued Emergency Order 20-006 to prohibit visitation to facilities housing groups of high-risk people, including assisted living facilities (ALFs). Regardless, 672 ALFs of the 3,019 in Florida had reported at least one positive […]

SARS-CoV-2 in Assisted Living: Mortality and Asymptomatic Infection

Apr 1, 2022
In response to a rapid rise in mortality within assisted living, facility-wide resident testing found 42% of 182 residents had SARS-CoV-2 infection; 68% of which were asymptomatic for 14 days before and after testing. Resident testing was a critical infection control measure needed to control transmission of SARS-CoV-2 infection.

SARS-CoV-2 in Assisted Living: Mortality and Asymptomatic Infection

by Lea Efird-Green

In response to a rapid rise in mortality within assisted living, facility-wide resident testing found 42% of 182 residents had SARS-CoV-2 infection; 68% of which were asymptomatic for 14 days before and after testing. Resident testing was a critical infection control measure needed to control transmission of SARS-CoV-2 infection.

“What Keeps Me Awake at Night”: Assisted Living Administrator Responses to COVID-19

Mar 1, 2022
Background and Objectives Assisted living (AL) constitutes an important sector of residential long-term care, yet there has been limited research about the impact of the coronavirus disease 2019 (COVID-19) pandemic in this setting. This qualitative study sought to understand the impact of the early stages of the pandemic (February–August 2020) from AL administrators’ perspectives. Research […]

“What Keeps Me Awake at Night”: Assisted Living Administrator Responses to COVID-19

by Lea Efird-Green

Background and Objectives Assisted living (AL) constitutes an important sector of residential long-term care, yet there has been limited research about the impact of the coronavirus disease 2019 (COVID-19) pandemic in this setting. This qualitative study sought to understand the impact of the early stages of the pandemic (February–August 2020) from AL administrators’ perspectives. Research […]

COVID-19 in Assisted Living: Protecting a Critical Long-Term Care Resource

Feb 16, 2022
The COVID-19 pandemic had a big impact on assisted living (AL), a vital setting in long-term care (LTC). Understanding the strengths and opportunities for improvement through practice, policy, and research are essential for AL to be prepared for the next pandemic and other challenges. AL communities experienced the pandemic in unique ways, because of varying […]

COVID-19 in Assisted Living: Protecting a Critical Long-Term Care Resource

by Lea Efird-Green

The COVID-19 pandemic had a big impact on assisted living (AL), a vital setting in long-term care (LTC). Understanding the strengths and opportunities for improvement through practice, policy, and research are essential for AL to be prepared for the next pandemic and other challenges. AL communities experienced the pandemic in unique ways, because of varying […]