Objective We investigate the changes in the sociodemographic characteristics, clinical comorbidities, and transitions between care settings among residents of assisted living facilities. Design Repeated cross-sectional study. Setting and Participants Linked, individual-level health system administrative data on residents of assisted living facilities in Ontario, Canada, from January 1, 2013, to December 31, 2019. Methods Counts and […]
Medical Care
Hospital Proximity and Emergency Department Use among Assisted Living Residents
Hospital Proximity and Emergency Department Use among Assisted Living Residents
Objectives To examine the relationship between AL communities’ distance to the nearest hospital and residents’ rates of emergency department (ED) use. We hypothesize that when access to an ED is more convenient, as measured by a shorter distance, assisted living (AL)-to-ED transfers are more common, particularly for nonemergent conditions. Design Retrospective cohort study, where the […]
Injury-Related Emergency Department Use among Assisted Living Residents with Alzheimer’s Disease and Related Dementias
Injury-Related Emergency Department Use among Assisted Living Residents with Alzheimer’s Disease and Related Dementias
Background Injuries are a leading cause of emergency department (ED) visits among older adults, and individuals with Alzheimer’s disease and related dementias (ADRD) may be at particular risk. We compared injury-related ED use among assisted living (AL) residents with and without ADRD and assessed differences in the risk of injury-related ED visits among individuals with […]
Recommendations for Medical and Mental Health Care in Assisted Living Based on an Expert Delphi Consensus Panel
Recommendations for Medical and Mental Health Care in Assisted Living Based on an Expert Delphi Consensus Panel
Importance: Assisted living (AL) is the largest provider of residential long-term care in the US, and the morbidity of AL residents has been rising. However, AL is not a health care setting, and concern has been growing about residents’ medical and mental health needs. No guidance exists to inform this care. Objective: To identify consensus […]
Health Care Use and Outcomes in Assisted Living Communities: Race, Ethnicity, and Dual Eligibility
Health Care Use and Outcomes in Assisted Living Communities: Race, Ethnicity, and Dual Eligibility
Assisted Living (AL) has become an important residential long-term care option in the United States, yet very little is known about the nature and quality of care received in this setting by racial/ethnic minorities or residents dually eligible for Medicare and Medicaid. Using calendar year 2018 Medicare data, we identified 255,564 fee-for-service Medicare beneficiaries age […]
Impact of Dentures on Oral Health-Related Quality of Life in Assisted Living Facility Elders, Guntur District, Andhra Pradesh
Impact of Dentures on Oral Health-Related Quality of Life in Assisted Living Facility Elders, Guntur District, Andhra Pradesh
Background: Dentures can improve dental function and appearance in older people, but they may reduce oral health-related quality of life. Further research is needed to determine how denture wearing affects the general health and well-being of assisted living home residents. Materials and Methods: A cross-sectional questionnaire-based study was performed among 587 inmates of old-age homes […]
Bridging the Transition to Assisted Living: A Framework for Faith Community Nursing
Bridging the Transition to Assisted Living: A Framework for Faith Community Nursing
The transition from independent living to assisted living is a significant life process that may be compared to crossing a bridge. Faith community nurses can support older adults through this transition. This article presents a conceptual meaning of transition, a framework with a spiritual dimension, and implications for Christian nurses. A case study illustrates how […]
Potential Side Effects and Adverse Events of Antipsychotic Use for Residents With Dementia in Assisted Living: Implications for Prescribers, Staff, and Families
Potential Side Effects and Adverse Events of Antipsychotic Use for Residents With Dementia in Assisted Living: Implications for Prescribers, Staff, and Families
WHAT THIS MEANS FOR YOU: This study examined the use of antipsychotic medications among residents with dementia in 91 AL communities across seven states. The prevalence of potential side effects was high (93%) and of possible adverse events low, (6%), potentially associated with medication side effects. Quetiapine (Seroquel) and risperidone (Risperdal) were the most frequently prescribed antipsychotics. Most, but not all, residents’ family members were aware of their relative’s antipsychotic use.
Impact of Function-Focused Care on Psychotropic Medications and Opioid Use among Assisted Living Residents
Impact of Function-Focused Care on Psychotropic Medications and Opioid Use among Assisted Living Residents
Objective: To test the impact of the Function Focused Care Intervention on use of psychotropic medications and opioids over a 12-month period in assisted living residents. Setting: The study included 794 residents from 85 general assisted living communities in the United States. The general assisted living communities that had at least 25 beds and 10 […]
The Impact of Cognitive Impairment on Clinical Symptoms, Physical Activity and Care Interactions among Residents in Assisted Living Settings
The Impact of Cognitive Impairment on Clinical Symptoms, Physical Activity and Care Interactions among Residents in Assisted Living Settings
WHAT THIS MEANS FOR YOU: This study included 550 AL residents from 59 communities, and assessed how cognitive impairment relates to physical activity, pain, and willingness to receive staff-assisted function-focused care. It found that cognitively impaired residents were less active, experienced more pain, and were less interested in staff-assisted function-focused care activities.
Model Testing of the Factors that Influence Performance of Function Focused Care and Function among Assisted Living Residents
Model Testing of the Factors that Influence Performance of Function Focused Care and Function among Assisted Living Residents
WHAT THIS MEANS FOR YOU: A study of 550 AL residents from 59 communities found that factors such as better physical and cognitive health, positive care interactions, and supportive environments were associated with increased participation in function-focused care. Additionally, for-profit communities had higher levels of function-focused care despite having residents with lower functioning.
Reimagining Medical Care in Assisted Living
Reimagining Medical Care in Assisted Living
WHAT THIS MEANS FOR YOU: Three industry-wide proposals were recommended to enhance medical care quality for AL residents: regular on-site medical visits; employing experienced professionals in long-term and end-of-life care; and the introduction of an AL medical director role to establish rules, staff qualifications, and collaboration. The researchers acknowledge that adaptations may be necessary to adhere to these recommendations due to community size and availability of resources.
Rapid Adoption of Electronic Health Record and Health Information Exchange among Assisted Living Communities, 2010–2018
Rapid Adoption of Electronic Health Record and Health Information Exchange among Assisted Living Communities, 2010–2018
WHAT THIS MEANS FOR YOU: This study examined the use of electronic health records (EHRs) and health information exchange (HIE) in AL between 2010 and 2018. Use varied based on AL size and ownership, with larger (26+ beds) and chain-owned communities more likely to use these technologies. Overall, adoption of these technologies increased from 2010 to 2018, but smaller communities had lower adoption rates.
Post-Acute Care Transitions and Outcomes among Medicare Beneficiaries in Assisted Living Communities
Post-Acute Care Transitions and Outcomes among Medicare Beneficiaries in Assisted Living Communities
WHAT THIS MEANS FOR YOU: Medicare data were used to analyze post-acute care referrals for over 104,000 assisted living residents. The most common referral after hospitalizations was to skilled nursing. Referrals to skilled nursing were associated with a lower likelihood of emergency department visits and hospital readmissions; however, there was higher likelihood of long-term skilled nursing placement and death.