Academic Publication

Trends in Assisted Living and Memory Care Supply from 2019 to 2023

Dec 1, 2025

Objectives: Describe geographic variation from 2019 to 2023 in assisted living (AL) and memory care supply, and its correlation with county-level characteristics. Design: Descriptive study of the supply of AL and memory care. Setting and participants: Licensed AL communities in the United States operating in 2019 and 2023. Methods: Data come from a national list […]

Trends in Assisted Living and Memory Care Supply from 2019 to 2023

December 1, 2025 by Lea Efird-Green

Objectives: Describe geographic variation from 2019 to 2023 in assisted living (AL) and memory care supply, and its correlation with county-level characteristics. Design: Descriptive study of the supply of AL and memory care. Setting and participants: Licensed AL communities in the United States operating in 2019 and 2023. Methods: Data come from a national list […]

Vaccination Rates Among Long-Term Care Staff During the COVID-19 Pandemic

Dec 1, 2025

Objective: The COVID-19 pandemic had a profound impact on long-term care facilities, particularly nursing homes and assisted living communities (ALCs), leading to high mortality rates among residents. Vaccination of residents and staff in long-term care mitigated virus spread. However, we know little about vaccine uptake in assisted living compared with the nursing home setting. The […]

Vaccination Rates Among Long-Term Care Staff During the COVID-19 Pandemic

December 1, 2025 by Lea Efird-Green

Objective: The COVID-19 pandemic had a profound impact on long-term care facilities, particularly nursing homes and assisted living communities (ALCs), leading to high mortality rates among residents. Vaccination of residents and staff in long-term care mitigated virus spread. However, we know little about vaccine uptake in assisted living compared with the nursing home setting. The […]

Exploring Safety Concerns in Assisted Living Communities: A Qualitative Comparison of Resident, Family, and Staff Perspectives

Dec 1, 2025

Objectives: Safety concerns in assisted living (AL) communities are critical, yet understudied from the perspectives of residents, family caregivers, and staff. This study aimed to explore and compare safety concerns across these 3 groups. Design: This qualitative study conducted structured interviews to identify safety concerns from the perspectives of residents, family caregivers, and staff. Setting […]

Exploring Safety Concerns in Assisted Living Communities: A Qualitative Comparison of Resident, Family, and Staff Perspectives

December 1, 2025 by Lea Efird-Green

Objectives: Safety concerns in assisted living (AL) communities are critical, yet understudied from the perspectives of residents, family caregivers, and staff. This study aimed to explore and compare safety concerns across these 3 groups. Design: This qualitative study conducted structured interviews to identify safety concerns from the perspectives of residents, family caregivers, and staff. Setting […]

Physical Activity and Sedentary Behavior in Assisted Living Residents: Feasibility and Acceptability of a Longitudinal Study

Dec 1, 2025

Older assisted living (AL) residents are at risk for decreasing physical activity (PA) and increasing sedentary behavior (SB), but the change is not well-documented. We aimed to (1) determine the feasibility and acceptability of a longitudinal study of PA/SB with accelerometers, tests of cognitive and physical function, and questionnaires, (2) establish a preliminary estimate of […]

Physical Activity and Sedentary Behavior in Assisted Living Residents: Feasibility and Acceptability of a Longitudinal Study

December 1, 2025 by Lea Efird-Green

Older assisted living (AL) residents are at risk for decreasing physical activity (PA) and increasing sedentary behavior (SB), but the change is not well-documented. We aimed to (1) determine the feasibility and acceptability of a longitudinal study of PA/SB with accelerometers, tests of cognitive and physical function, and questionnaires, (2) establish a preliminary estimate of […]

End-of-Life Outcomes and Staff Visits for Hospice Recipients Residing in Assisted Living

Dec 1, 2025

Objectives: To examine (1) whether hospice staff visits are associated with end-of-life (EOL) transitions, place of death (POD), and live discharges among assisted living (AL) residents, and (2) whether state AL regulations on staffing and medication administration influence these outcomes. We hypothesized that more frequent staff visits and specific regulatory provisions would be associated with […]

End-of-Life Outcomes and Staff Visits for Hospice Recipients Residing in Assisted Living

December 1, 2025 by Lea Efird-Green

Objectives: To examine (1) whether hospice staff visits are associated with end-of-life (EOL) transitions, place of death (POD), and live discharges among assisted living (AL) residents, and (2) whether state AL regulations on staffing and medication administration influence these outcomes. We hypothesized that more frequent staff visits and specific regulatory provisions would be associated with […]

Barriers and Facilitators to Physical Activity Among Older Adults in Residential Aged Care Facilities: A Mixed Methods Systematic Review Using the Social Ecological Model

Dec 1, 2025

Objective: To ascertain the barriers and facilitators to physical activity (PA) for older adults in Residential Aged Care Facilities (RACFs), from the perspective of residents, staff, and family.Methods: A mixed-methods systematic review, underpinned by the Social Ecological Model (SEM). Five databases were searched from inception to May 2024. Data synthesis followed a convergent integrated approach, […]

Barriers and Facilitators to Physical Activity Among Older Adults in Residential Aged Care Facilities: A Mixed Methods Systematic Review Using the Social Ecological Model

December 1, 2025 by Lea Efird-Green

Objective: To ascertain the barriers and facilitators to physical activity (PA) for older adults in Residential Aged Care Facilities (RACFs), from the perspective of residents, staff, and family.Methods: A mixed-methods systematic review, underpinned by the Social Ecological Model (SEM). Five databases were searched from inception to May 2024. Data synthesis followed a convergent integrated approach, […]

Vision Impairment is a Risk Factor for Malnutrition in Older Long-Term Care Residents

Dec 1, 2025

Purpose: To examine how vision is associated with nutritional status in long-term residents. Methods: Voluntary residents of 47 assisted-living facilities and 7 nursing homes, including 2513 permanent long-term care residents (age ≥ 65 years) were examined by trained nurses about various health-related aspects. Nutritional status was assessed using the Mini Nutritional Assessment long version and […]

Vision Impairment is a Risk Factor for Malnutrition in Older Long-Term Care Residents

December 1, 2025 by Lea Efird-Green

Purpose: To examine how vision is associated with nutritional status in long-term residents. Methods: Voluntary residents of 47 assisted-living facilities and 7 nursing homes, including 2513 permanent long-term care residents (age ≥ 65 years) were examined by trained nurses about various health-related aspects. Nutritional status was assessed using the Mini Nutritional Assessment long version and […]

Personal Care Aide Staffing in U.S. Residential Care Communities: The Role of Aide Training Hours, Training Reimbursement, and Organizational Structures

Dec 1, 2025

Residential care communities (RCCs) employ nearly 660,000 personal care aides but few studies have examined personal care aide staffing nationwide. This study examines RCC characteristics associated with aide hours per resident day. We used the 2022 National Post-acute and Long-term Care Study to analyze variables of interest without missing data (n = 518) and produced […]

Personal Care Aide Staffing in U.S. Residential Care Communities: The Role of Aide Training Hours, Training Reimbursement, and Organizational Structures

December 1, 2025 by Lea Efird-Green

Residential care communities (RCCs) employ nearly 660,000 personal care aides but few studies have examined personal care aide staffing nationwide. This study examines RCC characteristics associated with aide hours per resident day. We used the 2022 National Post-acute and Long-term Care Study to analyze variables of interest without missing data (n = 518) and produced […]

Implementation and Acceptance of Oral Health Assessment Tools in Residential Aged Care Facilities: A Scoping Review

Dec 1, 2025

Background: The global ageing population has increased demand for healthcare services in residential aged care (RAC), with oral health recognised as crucial for overall well-being. Despite this, the implementation of oral health assessment tools in RAC faces significant challenges. Objective: This scoping review explored the implementation and acceptance of oral health assessment tools in RAC […]

Implementation and Acceptance of Oral Health Assessment Tools in Residential Aged Care Facilities: A Scoping Review

December 1, 2025 by Lea Efird-Green

Background: The global ageing population has increased demand for healthcare services in residential aged care (RAC), with oral health recognised as crucial for overall well-being. Despite this, the implementation of oral health assessment tools in RAC faces significant challenges. Objective: This scoping review explored the implementation and acceptance of oral health assessment tools in RAC […]

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

Nov 1, 2025

This study aimed to describe exercise programs in assisted living facilities (ALFs) across 12 facilities (totalling 1167 residents at the time) in an urban area of the United States, involving 216 residents (18.51%, 216/1167) who were able to walk to the activity room with or without assistive devices. Data collected included participant demographics, activity director […]

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

November 1, 2025 by Lea Efird-Green

This study aimed to describe exercise programs in assisted living facilities (ALFs) across 12 facilities (totalling 1167 residents at the time) in an urban area of the United States, involving 216 residents (18.51%, 216/1167) who were able to walk to the activity room with or without assistive devices. Data collected included participant demographics, activity director […]

Trends in Private Equity Acquisitions of Assisted Living Facilities

Nov 1, 2025

No abstract available

Trends in Private Equity Acquisitions of Assisted Living Facilities

November 1, 2025 by Lea Efird-Green

No abstract available

Prevalence of Suicidal Behaviors in Residents of Long-Term Care Facilities: A Systematic Review and Meta-Analysis

Nov 1, 2025

Background: Long-term care facilities (LTC) plays a pivotal role in caring for geriatric population. However, the risk of suicide in long-term care institutions among older individuals is little understood (e.g., nursing homes, assisted living facilities).Objective: The purpose of this systematic review is to pool and meta-analyze the data on prevalence of suicidal behaviors in geriatric […]

Prevalence of Suicidal Behaviors in Residents of Long-Term Care Facilities: A Systematic Review and Meta-Analysis

November 1, 2025 by Lea Efird-Green

Background: Long-term care facilities (LTC) plays a pivotal role in caring for geriatric population. However, the risk of suicide in long-term care institutions among older individuals is little understood (e.g., nursing homes, assisted living facilities).Objective: The purpose of this systematic review is to pool and meta-analyze the data on prevalence of suicidal behaviors in geriatric […]

Virtual House Calls: Using Digital Health Technology for Populations in Assisted Living

Nov 1, 2025

No abstract available

Virtual House Calls: Using Digital Health Technology for Populations in Assisted Living

November 1, 2025 by Lea Efird-Green

No abstract available

The National Dementia Workforce Study: Perspective From the National Institute on Aging

Nov 1, 2025

As the population of individuals living with Alzheimer’s disease and related dementias (AD/ADRD) continues to grow, so does the need for a well-prepared and stable dementia care workforce. The National Dementia Workforce Study (NDWS) represents a significant investment to understand the demographics, experiences, and magnitude and scope of challenges faced by the professional and direct […]

The National Dementia Workforce Study: Perspective From the National Institute on Aging

November 1, 2025 by Lea Efird-Green

As the population of individuals living with Alzheimer’s disease and related dementias (AD/ADRD) continues to grow, so does the need for a well-prepared and stable dementia care workforce. The National Dementia Workforce Study (NDWS) represents a significant investment to understand the demographics, experiences, and magnitude and scope of challenges faced by the professional and direct […]

The National Dementia Workforce Study: Development of Questionnaires for Home Care, Assisted Living, and Nursing Home Settings

Nov 1, 2025

The growing aging population and rising prevalence of dementia are driving increased demand for long-term care services and supports in the United States. People with dementia require substantial support and care, often from direct care workers in private homes, assisted living communities, and nursing homes. Despite their crucial role, these workers receive highly variable training, […]

The National Dementia Workforce Study: Development of Questionnaires for Home Care, Assisted Living, and Nursing Home Settings

November 1, 2025 by Lea Efird-Green

The growing aging population and rising prevalence of dementia are driving increased demand for long-term care services and supports in the United States. People with dementia require substantial support and care, often from direct care workers in private homes, assisted living communities, and nursing homes. Despite their crucial role, these workers receive highly variable training, […]

The National Dementia Workforce Study: The Plan for Organization Sample Frames and Data Collection

Nov 1, 2025

The National Dementia Workforce Study was designed to improve our understanding of the individuals and systems who care for people with dementia, but designing and implementing such a study is challenging due to the large number of patient care organizations, clinical and direct care roles, and locations in which care is provided. Specifically, developing a […]

The National Dementia Workforce Study: The Plan for Organization Sample Frames and Data Collection

November 1, 2025 by Lea Efird-Green

The National Dementia Workforce Study was designed to improve our understanding of the individuals and systems who care for people with dementia, but designing and implementing such a study is challenging due to the large number of patient care organizations, clinical and direct care roles, and locations in which care is provided. Specifically, developing a […]

A Person-Centred Approach to Further Develop a Digital Tool (KOKU-Nut) by Developing a Nutrition Game for Older Adults Living in the Community

Nov 1, 2025

Background: Digital tools embedded with behaviour change theories can encourage the successful implementation and maintenance of positive lifestyle changes. Keep on Keep up (KOKU) is a wellbeing app offering strength and balance exercises and educational games to raise awareness of fall prevention. We aimed to further develop KOKU using a person-centred approach to inform and […]

A Person-Centred Approach to Further Develop a Digital Tool (KOKU-Nut) by Developing a Nutrition Game for Older Adults Living in the Community

November 1, 2025 by Lea Efird-Green

Background: Digital tools embedded with behaviour change theories can encourage the successful implementation and maintenance of positive lifestyle changes. Keep on Keep up (KOKU) is a wellbeing app offering strength and balance exercises and educational games to raise awareness of fall prevention. We aimed to further develop KOKU using a person-centred approach to inform and […]

Factors Associated with the Variation in Drug Prescription of Antipsychotics in Long-Term Care Facilities: A Systematic Review

Nov 1, 2025

Background: Despite warnings and strict guidelines, the use of antipsychotics in long-term care facilities (LTCFs) remains problematic worldwide. Several factors, including facility and resident characteristics, could influence prescription practices. Given the vulnerability of the older people, this systematic review aims to analyze the key factors leading to variations in antipsychotic prescribing practices in LTCFs. Method: […]

Factors Associated with the Variation in Drug Prescription of Antipsychotics in Long-Term Care Facilities: A Systematic Review

November 1, 2025 by Lea Efird-Green

Background: Despite warnings and strict guidelines, the use of antipsychotics in long-term care facilities (LTCFs) remains problematic worldwide. Several factors, including facility and resident characteristics, could influence prescription practices. Given the vulnerability of the older people, this systematic review aims to analyze the key factors leading to variations in antipsychotic prescribing practices in LTCFs. Method: […]

Comparing Outcomes Among Medicaid Home and Community-Based Service Users: Private Homes vs. Assisted Living Facilities

Oct 1, 2025

Objective: To compare outcomes of Medicaid home and community-based services (HCBS) users residing in a private home vs. in an assisted living facility among dually eligible individuals aged 65 or older. Study setting and design: Medicaid HCBS occurred either in private homes or assisted living facilities in 883 counties in 39 states in the United […]

Comparing Outcomes Among Medicaid Home and Community-Based Service Users: Private Homes vs. Assisted Living Facilities

October 1, 2025 by Lea Efird-Green

Objective: To compare outcomes of Medicaid home and community-based services (HCBS) users residing in a private home vs. in an assisted living facility among dually eligible individuals aged 65 or older. Study setting and design: Medicaid HCBS occurred either in private homes or assisted living facilities in 883 counties in 39 states in the United […]

Dialectical Behavioral Therapy Skills Training in Assisted Living: Transdiagnostic Effects on Goal Attainment, Self-Efficacy, and Symptom Severity

Oct 1, 2025

Background: Dialectical Behavior Therapy Skills Training (DBT-ST) is an evidence-based intervention targeting emotion regulation, self-efficacy, and psychological well-being. While widely applied in clinical settings, its effectiveness and feasibility in long-term residential care remain underexplored. This study hypothesized that an 8-week DBT-ST program would increase goal attainment and self-efficacy, and decrease psychological distress among assisted living […]

Dialectical Behavioral Therapy Skills Training in Assisted Living: Transdiagnostic Effects on Goal Attainment, Self-Efficacy, and Symptom Severity

October 1, 2025 by Lea Efird-Green

Background: Dialectical Behavior Therapy Skills Training (DBT-ST) is an evidence-based intervention targeting emotion regulation, self-efficacy, and psychological well-being. While widely applied in clinical settings, its effectiveness and feasibility in long-term residential care remain underexplored. This study hypothesized that an 8-week DBT-ST program would increase goal attainment and self-efficacy, and decrease psychological distress among assisted living […]

The Relationship Between Home and Community-Based Services Utilization and Self-Reported Quality of Life for Community-Dwelling and Assisted Living Residents with and without Dementia

Oct 1, 2025

Background and objectives: Home and community-based services (HCBS) intend to allow individuals to age in their home or a home-like environment. The relationship between receiving specific types of HCBS and person-reported HCBS quality remains unclear. Research design and methods: We linked data on HCBS quality from 1413 respondents of the 2018 Minnesota National Core Indicators-Aging […]

The Relationship Between Home and Community-Based Services Utilization and Self-Reported Quality of Life for Community-Dwelling and Assisted Living Residents with and without Dementia

October 1, 2025 by Lea Efird-Green

Background and objectives: Home and community-based services (HCBS) intend to allow individuals to age in their home or a home-like environment. The relationship between receiving specific types of HCBS and person-reported HCBS quality remains unclear. Research design and methods: We linked data on HCBS quality from 1413 respondents of the 2018 Minnesota National Core Indicators-Aging […]

“What Good Is That?”-Perspectives of Using Telehealth to Discuss Serious Illness with Urban-Dwelling Low-Income Older Adults in Assisted Living

Oct 1, 2025

Telehealth offers an avenue for older adults to access providers, discuss care needs, and have serious illness conversations. However, telehealth is embraced by some and not by others. Urban-dwelling, low-income older adults have unique challenges in accessing continuous care, engaging with the healthcare system and receiving support to address serious illness care needs. To investigate […]

“What Good Is That?”-Perspectives of Using Telehealth to Discuss Serious Illness with Urban-Dwelling Low-Income Older Adults in Assisted Living

October 1, 2025 by Lea Efird-Green

Telehealth offers an avenue for older adults to access providers, discuss care needs, and have serious illness conversations. However, telehealth is embraced by some and not by others. Urban-dwelling, low-income older adults have unique challenges in accessing continuous care, engaging with the healthcare system and receiving support to address serious illness care needs. To investigate […]