The purpose of this study was to investigate responses to death at multiple levels within the assisted living (AL) system and to characterize the psychosocial impact of death on surviving residents. This study used secondary thematic analysis of multiple data sources collected as part of a larger quantitative-focused study with 21 ALs. Data sources included: […]
Academic Publication
Psychotropic and Pain Medication Use in Nursing Homes and Assisted Living Facilities during COVID-19
No abstract available.
Monitoring Laboratory Parameters for Drug Toxicity in Assisted Living Facilities
Monitoring Laboratory Parameters for Drug Toxicity in Assisted Living Facilities
No abstract available.
“What Keeps Me Awake at Night”: Assisted Living Administrator Responses to COVID-19
“What Keeps Me Awake at Night”: Assisted Living Administrator Responses to COVID-19
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 […]
Factors Associated With Assisted Living Facility Closure
Factors Associated With Assisted Living Facility Closure
Background and Objectives Assisted living facilities (ALFs) have experienced rapid growth in the past few decades. The expansion in the number of ALFs may cause markets to become oversaturated, and a greater risk of unprofitable ALFs to close. However, no studies have investigated ALF closure. This study adapted a model developed for the nursing home […]
Staff Reports of Behavioral Expressions of Persons with Dementia in 250 Assisted Living Communities
Staff Reports of Behavioral Expressions of Persons with Dementia in 250 Assisted Living Communities
Background and Objectives Assisted living (AL) residents with dementia commonly exhibit behavioral expressions (BEs), yet no study has examined how AL staff perceive and respond to BEs in terms of the “ABC” model of antecedents, behaviors, and consequences, or how perceptions relate to organizational characteristics. Understanding staff perceptions may inform interventions. Research Design and Methods […]
Assisted Living Residents With Dementia: Being Out in the World and Negotiating Connections
Assisted Living Residents With Dementia: Being Out in the World and Negotiating Connections
Background and Objectives Persons living with dementia, including long-term care residents, and their care partners emphasize the importance of meaningful engagement and stress the need for activity and opportunities to go outdoors or offsite. Yet, little is known about getting out in this population. Here, our objectives are to (a) identify residents’ opportunities for, and […]
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 […]
COVID-19 in Assisted Living: Protecting a Critical Long-Term Care Resource
COVID-19 in Assisted Living: Protecting a Critical Long-Term Care Resource
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 […]
“Uncivilized Children” or “Victims of Dementia”: Interpretations of Aggression in Older Assisted Living Tenants
“Uncivilized Children” or “Victims of Dementia”: Interpretations of Aggression in Older Assisted Living Tenants
WHAT THIS MEANS FOR YOU: Researchers interviewed 13 AL residents and 19 care workers in two communities about resident aggression. Care workers reported physical and verbal aggression, while residents reported relational and sexual aggression from peers. Both groups often attributed aggression to communal living, aging, or dementia, suggesting that they normalized the behavior and often did not report it. Underreporting of resident aggression was more common for workers than residents.
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.
Storage Issues in Assisted Living Facilities and Senior Living Communities
Storage Issues in Assisted Living Facilities and Senior Living Communities
WHAT THIS MEANS FOR YOU: During the COVID-19 pandemic, AL communities faced hurdles obtaining vital supplies including masks and gloves; AL communities were often considered lower priority than other healthcare settings, leading to delays in receipt. When supplies were obtained, the quantity often overwhelmed available storage space, leading to unsafe supply storage. Solutions include improved emergency management, emphasizing proper storage, and optimizing delivery schedules.
State Variation in Potentially Burdensome Transitions among Assisted Living Residents at the End of Life
State Variation in Potentially Burdensome Transitions among Assisted Living Residents at the End of Life
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.
Assisted Living Administrators’ Approaches to Advance Care Planning
Assisted Living Administrators’ Approaches to Advance Care Planning
WHAT THIS MEANS FOR YOU: Interviews with 27 AL administrators revealed different approaches to advanced care planning (ACP). They all acknowledged the importance of ACP and often discussed topics like “do-not-resuscitate” orders when new residents arrived. Challenges included insufficient ACP training for staff and administrators and some reluctance from residents and families to discuss ACP. Most communities lacked a systematic, structured ACP approach.
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.
Implementing Large-Scale Data-Driven Quality Improvement in Assisted Living
Implementing Large-Scale Data-Driven Quality Improvement in Assisted Living
Objectives Develop and evaluate the implementation of a proposed model for large-scale data-driven quality improvement in assisted living. Design We conducted a mixed-methods evaluation of the implementation of a large-scale data-driven quality improvement collaborative of Wisconsin assisted living communities (ALCs). Setting and Participants The model has been voluntarily implemented by 810 Wisconsin-licensed ALCs serving >20,000 […]
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.
State Medicaid Financing and Access to Large Assisted Living Settings for Medicare–Medicaid Dual-Eligibles
State Medicaid Financing and Access to Large Assisted Living Settings for Medicare–Medicaid Dual-Eligibles
WHAT THIS MEANS FOR YOU: This study examined two groups of Medicare beneficiaries residing in large (25+ beds) AL communities in 2014: dual Medicare and Medicaid beneficiaries, and Medicare-only beneficiaries. Among 506,193 beneficiaries, 18% were dually eligible; they tended to be younger, minority, and have more chronic health conditions. The share of dual-eligibles by state varied widely; states with Medicaid financing for AL had more dual-eligibles, but variation in state room and board regulations did not have a significant relationship to dual-eligible rates.
Memory Care Reduces Nursing Home Admissions among Assisted-Living Residents with Dementia
Memory Care Reduces Nursing Home Admissions among Assisted-Living Residents with Dementia
Introduction We compare nursing-home and hospital admissions among residents with Alzheimer’s disease and related dementias (ADRD) in memory-care assisted living to those in general assisted living. Methods Retrospective study of Medicare beneficiaries with ADRD in large (>25 bed) assisted-living communities. We compared admission to a hospital, to a nursing home, and long-term (>90 day) admission […]
Social Networks in Retirement and Assisted Living Communities: A Literature Review
Social Networks in Retirement and Assisted Living Communities: A Literature Review
WHAT THIS MEANS FOR YOU: A systematic review showed that from 2015 to 2020, older adults in AL or retirement communities who had stronger social connections experienced improved health, and that over-reliance on only family for social interactions was associated with loneliness. Related recommendations to reduce loneliness include fostering diverse social networks and overcoming barriers like the inability to select roommates, lack of phone access, and potentially isolating community layouts.
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.
Prevalence and Persistency of Deficiency Citations in Florida Assisted Living Facilities
Prevalence and Persistency of Deficiency Citations in Florida Assisted Living Facilities
WHAT THIS MEANS FOR YOU: State inspection data from 957 large assisted living communities in Florida showed that 87% were cited one or more times from 2012 to 2018. For-profit communities, those with more than 100 beds, and those with a limited mental health license were cited more often. Over 40% of communities were cited in two or more years for the same deficiency category, meaning that repeat citations are common.