Improving Fire Safety In Assisted Living
Quality Improvement
CEAL@UNC Strategic Advisor Presentations
CEAL@UNC regularly invites organizations and individuals committed to advancing well-being in assisted living through practice, research, and policy to present emerging and relevant topics to its Strategic Advisors. View Presentations
CEAL@UNC Strategic Advisor Presentations
CEAL@UNC regularly invites organizations and individuals committed to advancing well-being in assisted living through practice, research, and policy to present emerging and relevant topics to its Strategic Advisors. View Presentations
Oregon Adult Foster/Care Home Technical Assistance Webinars
Shared Risk in Assisted Living: Awakening a Sleeping Giant
Optimizing Ethical Care, Quality, and Safety in Long-Term Services and Supports: A Position Paper from the American College of Physicians
Long-term services and supports (LTSS) in the United States have faced substantial and enduring challenges. They encompass services for persons who can no longer independently care for themselves because of cognitive decline, functional limitations, chronic illness, or the sequelae of such conditions. These services are delivered in institutional and noninstitutional settings, such as nursing homes, […]
Optimizing Ethical Care, Quality, and Safety in Long-Term Services and Supports: A Position Paper from the American College of Physicians
Long-term services and supports (LTSS) in the United States have faced substantial and enduring challenges. They encompass services for persons who can no longer independently care for themselves because of cognitive decline, functional limitations, chronic illness, or the sequelae of such conditions. These services are delivered in institutional and noninstitutional settings, such as nursing homes, […]
The Importance of Nature and Wishes for Nature-Based Experiences Among Older Adults in Assisted Living Facilities
Nature-based interventions potentially support physical, mental, and social health. Understanding the needs of the target group is essential when developing such methods as part-of-care. This cross-sectional mixed method survey explores the wishes for nature-based experiences among older adults in assisted living facilities, 854 respondents were included. Diagnoses were confirmed from medical records, while functioning, wellbeing […]
The Importance of Nature and Wishes for Nature-Based Experiences Among Older Adults in Assisted Living Facilities
Nature-based interventions potentially support physical, mental, and social health. Understanding the needs of the target group is essential when developing such methods as part-of-care. This cross-sectional mixed method survey explores the wishes for nature-based experiences among older adults in assisted living facilities, 854 respondents were included. Diagnoses were confirmed from medical records, while functioning, wellbeing […]
Differences in Quality of Care Interactions Across Care Tasks in Assisted Living
Background: The quality of care interactions is crucial for the quality of life of assisted living residents. However, limited research has explored how interaction quality varies across different care tasks. Purpose: This study aimed to assess whether the quality of care interactions differs by care task type in assisted living communities. Methods: This was a […]
Differences in Quality of Care Interactions Across Care Tasks in Assisted Living
Background: The quality of care interactions is crucial for the quality of life of assisted living residents. However, limited research has explored how interaction quality varies across different care tasks. Purpose: This study aimed to assess whether the quality of care interactions differs by care task type in assisted living communities. Methods: This was a […]
A Qualitative Analysis of Safety Culture in Minnesota’s Assisted Living Facilities
Background and objectives: The number of assisted living facilities and people living in them is growing; however, there is considerable variation in state regulations for assisted living. Therefore, it is important for states with new or changed regulations to provide lessons learned for regulation and patient safety purposes. Research design and methods: Using qualitative thematic […]
A Qualitative Analysis of Safety Culture in Minnesota’s Assisted Living Facilities
Background and objectives: The number of assisted living facilities and people living in them is growing; however, there is considerable variation in state regulations for assisted living. Therefore, it is important for states with new or changed regulations to provide lessons learned for regulation and patient safety purposes. Research design and methods: Using qualitative thematic […]
Salutogenic Architecture, Non-Therapeutic Environments and the Health of the Elderly: A Systematic Review
Background: Despite a lot of studies that have been conducted on the effects of the built environment on the health of the elderly and environmental salutogenic factors, a limited number of studies have investigated the architectural physical factors clearly. Purpose and Aim: This paper investigated the architectural elements in the non-therapeutic built environment that can […]
Salutogenic Architecture, Non-Therapeutic Environments and the Health of the Elderly: A Systematic Review
Background: Despite a lot of studies that have been conducted on the effects of the built environment on the health of the elderly and environmental salutogenic factors, a limited number of studies have investigated the architectural physical factors clearly. Purpose and Aim: This paper investigated the architectural elements in the non-therapeutic built environment that can […]
Advancing Excellence in Assisted Living: The Evolution of CEAL@UNC
Keeping Assisted Living Communities Secure a Comprehensive Approach from the Perimeter to the Interior
Security in assisted living communities (ALFs) is essential to ensuring the safety and well-being of residents, staff, and visitors while maintaining regulatory compliance. A comprehensive security strategy involves multiple layers, from securing the perimeter with fencing, controlled entry points, surveillance, and lighting to implementing advanced interior security measures such as access control systems, emergency alerts, […]
Keeping Assisted Living Communities Secure a Comprehensive Approach from the Perimeter to the Interior
Security in assisted living communities (ALFs) is essential to ensuring the safety and well-being of residents, staff, and visitors while maintaining regulatory compliance. A comprehensive security strategy involves multiple layers, from securing the perimeter with fencing, controlled entry points, surveillance, and lighting to implementing advanced interior security measures such as access control systems, emergency alerts, […]
“Nobody Can Be Equipped for This”: Advice from New Residents of Long-Term Care Facilities
Background: The transition into a long-term care facility (LTCF) is difficult for older adults, prompting calls for clinicians to help guide and plan. Yet we know little about how those with lived experience of moving into an LTCF would advise others. Methods: We conducted in-person semi-structured interviews with nursing home (NH) and assisted living (AL) […]
“Nobody Can Be Equipped for This”: Advice from New Residents of Long-Term Care Facilities
Background: The transition into a long-term care facility (LTCF) is difficult for older adults, prompting calls for clinicians to help guide and plan. Yet we know little about how those with lived experience of moving into an LTCF would advise others. Methods: We conducted in-person semi-structured interviews with nursing home (NH) and assisted living (AL) […]
CEAL@UNC Guest Columns: McKnight’s Senior Living
Dr. Sheryl Zimmerman, Executive Director of CEAL@UNC, is a guest columnist for McKnight’s Senior Living. These regularly published articles reflect the perspectives of CEAL@UNC advisors, and address timely topics relevant to the well-being of the people who live and work in assisted living. View Articles
CEAL@UNC Guest Columns: McKnight’s Senior Living
Dr. Sheryl Zimmerman, Executive Director of CEAL@UNC, is a guest columnist for McKnight’s Senior Living. These regularly published articles reflect the perspectives of CEAL@UNC advisors, and address timely topics relevant to the well-being of the people who live and work in assisted living. View Articles
What Happens Behind Closed Doors? Investigating Care Practices in Nursing Home and Assisted Living Memory Care Units
In the United States, long-term care providers, such as nursing homes and assisted living communities, are meeting consumer demand through housing and care options designed to support the growing population of people living with dementia. One approach to providing dementia care is the development of “memory care units” within existing nursing homes and assisted living […]
What Happens Behind Closed Doors? Investigating Care Practices in Nursing Home and Assisted Living Memory Care Units
In the United States, long-term care providers, such as nursing homes and assisted living communities, are meeting consumer demand through housing and care options designed to support the growing population of people living with dementia. One approach to providing dementia care is the development of “memory care units” within existing nursing homes and assisted living […]
Two New Positive Psychosocial Measures for Persons Living with Dementia
Introduction: Differences in adaptive strategies used by individuals and families living with dementia have the potential to impact day-to-day well-being. The Living Well Inventory for Dementia (LWI-D) is a new measure to capture these strategies and to illuminate new options to support families living with dementia. The Quality of Day Scale (QODS) is a new […]
Two New Positive Psychosocial Measures for Persons Living with Dementia
Introduction: Differences in adaptive strategies used by individuals and families living with dementia have the potential to impact day-to-day well-being. The Living Well Inventory for Dementia (LWI-D) is a new measure to capture these strategies and to illuminate new options to support families living with dementia. The Quality of Day Scale (QODS) is a new […]
A Cluster Randomized Controlled Trial of Visual Cues, Signage, and Spaced Retrieval for Wayfinding Within Long-Term Care Communities
Background and Objectives: Wayfinding can be challenging in many long-term care communities (LTCCs) due to size, poor visibility, inadequate wayfinding design, as well as cognitive impairment of some residents. The purpose of this study was to investigate the effects of distinctive cues and signage placed at key points within care communities, with and without a […]
A Cluster Randomized Controlled Trial of Visual Cues, Signage, and Spaced Retrieval for Wayfinding Within Long-Term Care Communities
Background and Objectives: Wayfinding can be challenging in many long-term care communities (LTCCs) due to size, poor visibility, inadequate wayfinding design, as well as cognitive impairment of some residents. The purpose of this study was to investigate the effects of distinctive cues and signage placed at key points within care communities, with and without a […]
Measurement of Quality in Assisted Living in the United States of America: A Scoping Review
Objectives: To identify different approaches (unique domains) and indicators to evaluate quality in assisted living communities in the United States. Design: Scoping review supplemented with key informant and technical panel guidance. Setting and Participants: Assisted living settings and residents. Methods: We obtained feedback on our review protocol and search strategy from key informants with expertise […]
Measurement of Quality in Assisted Living in the United States of America: A Scoping Review
Objectives: To identify different approaches (unique domains) and indicators to evaluate quality in assisted living communities in the United States. Design: Scoping review supplemented with key informant and technical panel guidance. Setting and Participants: Assisted living settings and residents. Methods: We obtained feedback on our review protocol and search strategy from key informants with expertise […]
Risk of Hospitalization Among Assisted Living Residents Dually Enrolled in Medicare and Medicaid
WHAT THIS MEANS FOR YOU: This retrospective cohort study used Medicare data from 2008-2018 from 12,451 AL communities to examine the risk of hospitalization for Medicare-Medicaid dual eligibles. Out of 620,542 Medicare beneficiaries, the 1-year risk of hospitalization was higher for dually enrolled individuals. The risk was higher in high-dual AL communities than in low-dual AL communities for both dually enrolled (7.4%) and Medicare only (9.4%) individuals.
Risk of Hospitalization Among Assisted Living Residents Dually Enrolled in Medicare and Medicaid
WHAT THIS MEANS FOR YOU: This retrospective cohort study used Medicare data from 2008-2018 from 12,451 AL communities to examine the risk of hospitalization for Medicare-Medicaid dual eligibles. Out of 620,542 Medicare beneficiaries, the 1-year risk of hospitalization was higher for dually enrolled individuals. The risk was higher in high-dual AL communities than in low-dual AL communities for both dually enrolled (7.4%) and Medicare only (9.4%) individuals.
Transitions to Nursing Homes Among Residents of Assisted Living and Community-Dwelling Home Care Recipients
This Canadian cohort study included 10,012 AL residents and 131,679 home care recipients who applied for beds in nursing homes to examine the transition differences between the 2 groups. There were 6,049 transitions from AL residents and 85,190 from home care to nursing homes. Living in an AL, rather than in the community, led to a roughly 13% decrease in the 5-year risk of transition to nursing homes despite similar relative clinical complexity and healthcare needs, meaning that assisted living is an important part of the long-term care continuum.
Transitions to Nursing Homes Among Residents of Assisted Living and Community-Dwelling Home Care Recipients
This Canadian cohort study included 10,012 AL residents and 131,679 home care recipients who applied for beds in nursing homes to examine the transition differences between the 2 groups. There were 6,049 transitions from AL residents and 85,190 from home care to nursing homes. Living in an AL, rather than in the community, led to a roughly 13% decrease in the 5-year risk of transition to nursing homes despite similar relative clinical complexity and healthcare needs, meaning that assisted living is an important part of the long-term care continuum.
Association Between Organizational Context and Resident Pain in Assisted Living: A Repeated Cross-Sectional Study
WHAT THIS MEANS FOR YOU: This repeated cross-sectional study linked survey data from COVID-19 waves 1 and 2 from 985 residents in 41 AL communities (wave 1) and 1134 residents in 42 AL communities (wave 2) to examine if organizational context was associated with resident pain. Overall pain prevalence decreased from 20.6% in wave 1 to 19.1% in wave 2, but it was non-significant.There were mixed results: better preparedness, room confinement, availability of a nurse practitioner, and staff shortages were associated with resident pain. Organizational context does therefore have an effect on resident pain, and future policy and management interventions should address these factors.
Association Between Organizational Context and Resident Pain in Assisted Living: A Repeated Cross-Sectional Study
WHAT THIS MEANS FOR YOU: This repeated cross-sectional study linked survey data from COVID-19 waves 1 and 2 from 985 residents in 41 AL communities (wave 1) and 1134 residents in 42 AL communities (wave 2) to examine if organizational context was associated with resident pain. Overall pain prevalence decreased from 20.6% in wave 1 to 19.1% in wave 2, but it was non-significant.There were mixed results: better preparedness, room confinement, availability of a nurse practitioner, and staff shortages were associated with resident pain. Organizational context does therefore have an effect on resident pain, and future policy and management interventions should address these factors.
Factors Associated with Transfer from Assisted Living Facilities to a Nursing Home: National Health Aging Trends Study 2011-2019
WHAT THIS MEANS FOR YOU: This analysis used the National Health Aging Trends Study to identify factors associated with transfer from an AL community to a nursing home. Data from 970 AL residents over seven years showed that those with better baseline physical performance and college education were at lower risk of transfer. Residents who maintained physical less and had less difficulty with basic activities of daily living (ADLs) were also at lower risk of transfer.
Factors Associated with Transfer from Assisted Living Facilities to a Nursing Home: National Health Aging Trends Study 2011-2019
WHAT THIS MEANS FOR YOU: This analysis used the National Health Aging Trends Study to identify factors associated with transfer from an AL community to a nursing home. Data from 970 AL residents over seven years showed that those with better baseline physical performance and college education were at lower risk of transfer. Residents who maintained physical less and had less difficulty with basic activities of daily living (ADLs) were also at lower risk of transfer.
Clinical and Sociodemographic Characteristics of New Residents of Assisted Living: A Nested Case-Control Study
WHAT THIS MEANS FOR YOU: This nested case-control study in Ontario examined differences between community-dwelling and new AL residents to understand transitions to AL communitiess. New residents had higher rates of diagnosed dementia, mood disorders, cardiac arrhythmias, mild cognitive impairment, and falls than community-dwelling peers. New AL residents also had lower odds of having a spousal caregiver than a child caregiver. However, these residents also had higher rates of participation in activities of interest in the last seven days.
Clinical and Sociodemographic Characteristics of New Residents of Assisted Living: A Nested Case-Control Study
WHAT THIS MEANS FOR YOU: This nested case-control study in Ontario examined differences between community-dwelling and new AL residents to understand transitions to AL communitiess. New residents had higher rates of diagnosed dementia, mood disorders, cardiac arrhythmias, mild cognitive impairment, and falls than community-dwelling peers. New AL residents also had lower odds of having a spousal caregiver than a child caregiver. However, these residents also had higher rates of participation in activities of interest in the last seven days.
Effect of a Digital Two-Dimensional Animation Program on Attitude Toward Walking Aids, Performance, and Fall Avoidance Behaviors among Older Adults in Assisted Living Facilities
WHAT THIS MEANS FOR YOU: This quasi-experimental study of 128 AL residents investigated the impact of a two-dimensional animation program on attitudes towards walking aids, performance and fall avoidance behaviors. The intervention group had more positive attitudes towards walking aids, improved walking aid use, and reduced fall concerns than the control group, meaning this teaching strategy could be effective to enhance mobility and reduce falls in this setting.
Effect of a Digital Two-Dimensional Animation Program on Attitude Toward Walking Aids, Performance, and Fall Avoidance Behaviors among Older Adults in Assisted Living Facilities
WHAT THIS MEANS FOR YOU: This quasi-experimental study of 128 AL residents investigated the impact of a two-dimensional animation program on attitudes towards walking aids, performance and fall avoidance behaviors. The intervention group had more positive attitudes towards walking aids, improved walking aid use, and reduced fall concerns than the control group, meaning this teaching strategy could be effective to enhance mobility and reduce falls in this setting.
Feasibility of a Novel Lighting System to Reduce Nighttime Falls in Assisted Living Residents With Dementia
WHAT THIS MEANS FOR YOU: This crossover trial examined 38 residents in 5 AL communities to test a new lighting system to reduce nighttime falls. Using cameras to capture falls, falls density was found to be 34% lower in the intervention condition than the control condition, although this reduction was not statistically significant. The results were promising enough to continue testing in a larger trial, which is ongoing.
Feasibility of a Novel Lighting System to Reduce Nighttime Falls in Assisted Living Residents With Dementia
WHAT THIS MEANS FOR YOU: This crossover trial examined 38 residents in 5 AL communities to test a new lighting system to reduce nighttime falls. Using cameras to capture falls, falls density was found to be 34% lower in the intervention condition than the control condition, although this reduction was not statistically significant. The results were promising enough to continue testing in a larger trial, which is ongoing.
