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.

Academic Publication

The Complexity of Providing Behavioral Healthcare in Assisted Living

Oct 1, 2023
WHAT THIS MEANS FOR YOU: This editorial discussed the difficulty providing mental and behavioral healthcare in assisted living. Increasing numbers of residents experience high rates of behavioral health issues, but only 40% of communities offer treatment for these issues, despite the fact that lack of treatment is associated with negative outcomes such as severe depression and suicidal ideation. To improve behavioral healthcare in assisted living, adequate staffing and staff education is required, as well as insurance reimbursements for mental health services at similar levels to those for medical care.

The Complexity of Providing Behavioral Healthcare in Assisted Living

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This editorial discussed the difficulty providing mental and behavioral healthcare in assisted living. Increasing numbers of residents experience high rates of behavioral health issues, but only 40% of communities offer treatment for these issues, despite the fact that lack of treatment is associated with negative outcomes such as severe depression and suicidal ideation. To improve behavioral healthcare in assisted living, adequate staffing and staff education is required, as well as insurance reimbursements for mental health services at similar levels to those for medical care.

Psychotropic, Anticonvulsant, and Opioid Use in Assisted Living Residents Before and During the COVID-19 Pandemic

Oct 1, 2023
WHAT THIS MEANS FOR YOU: Administrative data from 256 assisted living communities in Alberta during the COVID-19 pandemic found that during waves 2 to 4, antipsychotic use increased, (significantly more for dementia care residents), and that anticonvulsant use increased for assisted living (but not dementia care) residents. Additionally, there was an increase in antidepressant use and a decrease in benzodiazepine use for both assisted living and dementia care residents. The persistence of a pandemic-associated increase in these medications raises concerns about well-established health and wellbeing impacts for residents.

Psychotropic, Anticonvulsant, and Opioid Use in Assisted Living Residents Before and During the COVID-19 Pandemic

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Administrative data from 256 assisted living communities in Alberta during the COVID-19 pandemic found that during waves 2 to 4, antipsychotic use increased, (significantly more for dementia care residents), and that anticonvulsant use increased for assisted living (but not dementia care) residents. Additionally, there was an increase in antidepressant use and a decrease in benzodiazepine use for both assisted living and dementia care residents. The persistence of a pandemic-associated increase in these medications raises concerns about well-established health and wellbeing impacts for residents.

Effect of Quarantine on Body Weight Among Residents of Assisted Living Facilities During the COVID-19 Pandemic

Sep 1, 2023
WHAT THIS MEANS FOR YOU: During the COVID-19 pandemic, 40% of 53 assisted living residents who had been in room quarantine experienced significant weight loss; men had a greater risk of significant weight loss than women. If quarantine is used for future epidemics, weight should be monitored and reported to avoid negative health outcomes associated with rapid weight loss.

Effect of Quarantine on Body Weight Among Residents of Assisted Living Facilities During the COVID-19 Pandemic

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: During the COVID-19 pandemic, 40% of 53 assisted living residents who had been in room quarantine experienced significant weight loss; men had a greater risk of significant weight loss than women. If quarantine is used for future epidemics, weight should be monitored and reported to avoid negative health outcomes associated with rapid weight loss.

Social Connectedness Resource Preferences of Older Adults in Assisted Living: A Scoping Review Based on the WHO-ICF Framework

Sep 1, 2023
WHAT THIS MEANS FOR YOU: A literature review examined the social activities preferred by assisted living residents, finding that residents preferred social activities organized by the community, such as games and outings. They also preferred civic life activities (e.g., volunteering) to connect with the broader community. Older residents and those living in larger communities tended to prefer activities provided by the community, while younger residents preferred more demanding physical activities.

Social Connectedness Resource Preferences of Older Adults in Assisted Living: A Scoping Review Based on the WHO-ICF Framework

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: A literature review examined the social activities preferred by assisted living residents, finding that residents preferred social activities organized by the community, such as games and outings. They also preferred civic life activities (e.g., volunteering) to connect with the broader community. Older residents and those living in larger communities tended to prefer activities provided by the community, while younger residents preferred more demanding physical activities.

Barriers to Infection Prevention and Control in Long-term Care/Assisted Living Settings in British Columbia During the COVID-19 Pandemic: A Cross-Sectional Survey

Aug 1, 2023
WHAT THIS MEANS FOR YOU: A study of over 1,300 health care workers and infection prevention and control (IPAC) professionals in British Columbia found that healthcare workers in long-term care/assisted living experienced more barriers following IPAC recommendations compared to those in acute care. Barriers included that IPAC was lower priority compared to other tasks; not their responsibility; that there were limited personal protective equipment, hand hygiene, and cleaning/disinfection products; deficits in IPAC leadership and support; limited IPAC education and training; and limited patient care knowledge for managing COVID-19 infections.

Barriers to Infection Prevention and Control in Long-term Care/Assisted Living Settings in British Columbia During the COVID-19 Pandemic: A Cross-Sectional Survey

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: A study of over 1,300 health care workers and infection prevention and control (IPAC) professionals in British Columbia found that healthcare workers in long-term care/assisted living experienced more barriers following IPAC recommendations compared to those in acute care. Barriers included that IPAC was lower priority compared to other tasks; not their responsibility; that there were limited personal protective equipment, hand hygiene, and cleaning/disinfection products; deficits in IPAC leadership and support; limited IPAC education and training; and limited patient care knowledge for managing COVID-19 infections.

A National Typology of Health Service Regulation in Assisted Living

Aug 1, 2023
WHAT THIS MEANS FOR YOU: This study categorized 350 assisted living state licensure types into six different types that differed by regulations about health services: housing, holistic, hybrid, hospitality, healthcare, and health support. This categorization may support consumer decision-making and improve the specificity of assisted living research and policy.

A National Typology of Health Service Regulation in Assisted Living

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study categorized 350 assisted living state licensure types into six different types that differed by regulations about health services: housing, holistic, hybrid, hospitality, healthcare, and health support. This categorization may support consumer decision-making and improve the specificity of assisted living research and policy.

Exploring Constraints to Well-Being for Older Adults in Transition Into an Assisted Living Home: A Qualitative Study

Jul 1, 2023
WHAT THIS MEANS FOR YOU: A theory-based thematic analysis was conducted on 14 interviews with assisted living residents from one community in the rural southeastern US. When asked to report experiences when transitioning to the community, residents felt a loss of independence, space, and belongings due to necessary downsizing. Results support the Modified Constraints to Wellbeing model, which theorizes that structural and intrapersonal constraints (e.g., loss of independence) lead to changes in social leisure pursuits after transitioning into assisted living, which negatively affects wellbeing. However, more research is needed.

Exploring Constraints to Well-Being for Older Adults in Transition Into an Assisted Living Home: A Qualitative Study

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: A theory-based thematic analysis was conducted on 14 interviews with assisted living residents from one community in the rural southeastern US. When asked to report experiences when transitioning to the community, residents felt a loss of independence, space, and belongings due to necessary downsizing. Results support the Modified Constraints to Wellbeing model, which theorizes that structural and intrapersonal constraints (e.g., loss of independence) lead to changes in social leisure pursuits after transitioning into assisted living, which negatively affects wellbeing. However, more research is needed.

Assisted Living or Nursing Home: Who is Moving In?

Jul 1, 2023
WHAT THIS MEANS FOR YOU: Medicare data examined the characteristics of over 770,000 individuals admitted to assisted living and nursing homes directly from the community between 2017 and 2019. Substantial differences were found between these two groups, including that racial/ethnic minorities, those dually eligible for Medicare and Medicaid, and those having two or more skilled nursing facility stays in the last six months were more likely to be admitted to a nursing home. On the other hand, those who were 75 years or older, male, had one skilled nursing facility or hospital stay, or were Medicare fee-for-service beneficiaries were more likely to be admitted to an assisted living community.

Assisted Living or Nursing Home: Who is Moving In?

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Medicare data examined the characteristics of over 770,000 individuals admitted to assisted living and nursing homes directly from the community between 2017 and 2019. Substantial differences were found between these two groups, including that racial/ethnic minorities, those dually eligible for Medicare and Medicaid, and those having two or more skilled nursing facility stays in the last six months were more likely to be admitted to a nursing home. On the other hand, those who were 75 years or older, male, had one skilled nursing facility or hospital stay, or were Medicare fee-for-service beneficiaries were more likely to be admitted to an assisted living community.

Comparing Quality of Care Outcomes Between Assisted Living and Nursing Homes Before and During the COVID-19 Pandemic

Jul 1, 2023
WHAT THIS MEANS FOR YOU: This study used Resident Assessment Instrument data from 2017-2021 in Alberta to examine quality indicator differences between assisted living and nursing home residents (over 2,000 assisted living and about 13,000 nursing home residents per quarter). Antipsychotic use and pain rates were consistently higher in assisted living, while depressive symptoms, dependency, restraint use, delirium, and weight loss were consistently higher in nursing homes. During the COVID-19 pandemic, antipsychotic use increased in both settings, and total dependency increased in assisted living.

Comparing Quality of Care Outcomes Between Assisted Living and Nursing Homes Before and During the COVID-19 Pandemic

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study used Resident Assessment Instrument data from 2017-2021 in Alberta to examine quality indicator differences between assisted living and nursing home residents (over 2,000 assisted living and about 13,000 nursing home residents per quarter). Antipsychotic use and pain rates were consistently higher in assisted living, while depressive symptoms, dependency, restraint use, delirium, and weight loss were consistently higher in nursing homes. During the COVID-19 pandemic, antipsychotic use increased in both settings, and total dependency increased in assisted living.

Clinical Comorbidities and Transitions Between Care Settings Among Residents of Assisted Living Facilities: A Repeated Cross-Sectional Study

Jul 1, 2023
WHAT THIS MEANS FOR YOU: Administrative data from 2013-2019 in Ontario, Canada found a 34% increase in the resident population, and residents experienced increased instances of health conditions including renal disease, mental health issues, cardiac arrhythmias, diabetes, and cancer. Approximately 20% of residents still lived in an assisted living community at the end of the 6-year period, while 10% transitioned to nursing homes. In less than a decade, data revealed increasing medical complexity of assisted living residents, which must be considered for improved policy and practice.

Clinical Comorbidities and Transitions Between Care Settings Among Residents of Assisted Living Facilities: A Repeated Cross-Sectional Study

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Administrative data from 2013-2019 in Ontario, Canada found a 34% increase in the resident population, and residents experienced increased instances of health conditions including renal disease, mental health issues, cardiac arrhythmias, diabetes, and cancer. Approximately 20% of residents still lived in an assisted living community at the end of the 6-year period, while 10% transitioned to nursing homes. In less than a decade, data revealed increasing medical complexity of assisted living residents, which must be considered for improved policy and practice.

Turning It Over to God: African American Assisted Living Residents’ End-of-Life Preferences and Advance Care Planning

Jul 1, 2023
WHAT THIS MEANS FOR YOU: A qualitative study in a 100-bed assisted living community catering to African American residents found that a shared belief that God was ultimately in control related to end-of-life and advance care planning preferences, although this relationship was influenced by other individual-level factors like age, pain, function, health literacy, and past experiences with healthcare.

Turning It Over to God: African American Assisted Living Residents’ End-of-Life Preferences and Advance Care Planning

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: A qualitative study in a 100-bed assisted living community catering to African American residents found that a shared belief that God was ultimately in control related to end-of-life and advance care planning preferences, although this relationship was influenced by other individual-level factors like age, pain, function, health literacy, and past experiences with healthcare.

End-of-Life Care Transitions in Assisted Living: Associations With State Staffing and Training Regulations

Jun 1, 2023
WHAT THIS MEANS FOR YOU: This study examined associations between end-of-life care transitions (meaning stays in hospitals and nursing homes in either the 7 or 30 days before death in this study) and state staffing and training requirements for nearly 114,000 Medicare beneficiaries who died in an assisted living community in 2018-2019. A higher proportion of transitions was associated with stricter regulations about licensed and direct care worker staffing, whereas a lower proportion was associated with more specific regulations about direct care worker training. Therefore, policymakers and practitioners may want to implement regulations that make staff training requirements more specific to better address end-of-life care.

End-of-Life Care Transitions in Assisted Living: Associations With State Staffing and Training Regulations

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study examined associations between end-of-life care transitions (meaning stays in hospitals and nursing homes in either the 7 or 30 days before death in this study) and state staffing and training requirements for nearly 114,000 Medicare beneficiaries who died in an assisted living community in 2018-2019. A higher proportion of transitions was associated with stricter regulations about licensed and direct care worker staffing, whereas a lower proportion was associated with more specific regulations about direct care worker training. Therefore, policymakers and practitioners may want to implement regulations that make staff training requirements more specific to better address end-of-life care.

Online Customer Reviews of Assisted Living Communities: Association with Community, County, and State Factors

Jun 1, 2023
WHAT THIS MEANS FOR YOU: In this study, almost 150,000 on-line consumer reviews from nearly 9,000 assisted living communities were analyzed in the context of community, county, and state variables (e.g., regulatory specificity, rurality). Communities with greater proportions of Medicare/Medicaid residents had lower odds of positive reviews, but communities in states with more direct care worker hours per week per bed had higher odds of positive reviews. Higher staffing may advantage positive consumer perceptions.

Online Customer Reviews of Assisted Living Communities: Association with Community, County, and State Factors

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: In this study, almost 150,000 on-line consumer reviews from nearly 9,000 assisted living communities were analyzed in the context of community, county, and state variables (e.g., regulatory specificity, rurality). Communities with greater proportions of Medicare/Medicaid residents had lower odds of positive reviews, but communities in states with more direct care worker hours per week per bed had higher odds of positive reviews. Higher staffing may advantage positive consumer perceptions.

Pathways into Assisted Living Communities: Admission Limitations and Assessment Requirements Across the United States

Jun 1, 2023
WHAT THIS MEANS FOR YOU: This study examined differences in who may be admitted to an assisted living community using regulatory data from 2018. Admission restrictions were categorized into 1) health-related conditions, 2) specified behavior, 3) mental health condition, and 4) cognitive impairment. Almost one-third (29%) of communities are governed by regulations limiting admission of individuals with only a health condition, and slightly fewer (24%) of communities have limitations based on all four categories. Just over 11% of AL communities have no restrictions on who may be admitted.

Pathways into Assisted Living Communities: Admission Limitations and Assessment Requirements Across the United States

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study examined differences in who may be admitted to an assisted living community using regulatory data from 2018. Admission restrictions were categorized into 1) health-related conditions, 2) specified behavior, 3) mental health condition, and 4) cognitive impairment. Almost one-third (29%) of communities are governed by regulations limiting admission of individuals with only a health condition, and slightly fewer (24%) of communities have limitations based on all four categories. Just over 11% of AL communities have no restrictions on who may be admitted.

State Regulations and Assisted Living Residents’ Potentially Burdensome Transitions at the End of Life

Jun 1, 2023
WHAT THIS MEANS FOR YOU: The study examined potentially burdensome end-of-life transitions (e.g., repeated hospitalizations) in relation to state regulations, using Medicare claims data for over 129,000 assisted living residents in communities with 25 or more beds between 2017-2019. There were no associations between transitions and regulations about third-party services or staffing, and small associations between transitions and medication management regulations. These inconclusive results indicate that more research is needed to understand the wide variety of end-of-life outcomes experienced by assisted living residents.

State Regulations and Assisted Living Residents’ Potentially Burdensome Transitions at the End of Life

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: The study examined potentially burdensome end-of-life transitions (e.g., repeated hospitalizations) in relation to state regulations, using Medicare claims data for over 129,000 assisted living residents in communities with 25 or more beds between 2017-2019. There were no associations between transitions and regulations about third-party services or staffing, and small associations between transitions and medication management regulations. These inconclusive results indicate that more research is needed to understand the wide variety of end-of-life outcomes experienced by assisted living residents.

Hospital Proximity and Emergency Department Use among Assisted Living Residents

Jun 1, 2023
WHAT THIS MEANS FOR YOU: This study assessed if the distance between AL communities and the nearest hospital was associated with the frequency of emergency department (ED) visits. Almost 541,000 Medicare beneficiaries aged 55 or older residing in over 16,500 AL communities in 2018-2019 were included. The median distance to the nearest hospital was 2.5 miles. Distance was related to ED use, especially for non-critical, visits, such that communities 5 or more miles from a hospital had fewer ED visits than those that were closer to a hospital.

Hospital Proximity and Emergency Department Use among Assisted Living Residents

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study assessed if the distance between AL communities and the nearest hospital was associated with the frequency of emergency department (ED) visits. Almost 541,000 Medicare beneficiaries aged 55 or older residing in over 16,500 AL communities in 2018-2019 were included. The median distance to the nearest hospital was 2.5 miles. Distance was related to ED use, especially for non-critical, visits, such that communities 5 or more miles from a hospital had fewer ED visits than those that were closer to a hospital.

Paperwork, Paradox, and PRN: Psychotropic Medication Deficiencies in Assisted Living

Jun 1, 2023
WHAT THIS MEANS FOR YOU: This study analyzed 170 psychotropic medication deficiency citations from 152 Oregon assisted living communities to determine discrepancies in state licensing and oversight of psychotropic medication use. It found most deficiencies involved documentation errors; there were unclear regulations for direct care workers who distribute medications; and there was a persistent disconnect about when to seek expertise before requesting psychotropic use.

Paperwork, Paradox, and PRN: Psychotropic Medication Deficiencies in Assisted Living

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study analyzed 170 psychotropic medication deficiency citations from 152 Oregon assisted living communities to determine discrepancies in state licensing and oversight of psychotropic medication use. It found most deficiencies involved documentation errors; there were unclear regulations for direct care workers who distribute medications; and there was a persistent disconnect about when to seek expertise before requesting psychotropic use.

“I Have a Lotta Sad Feelin'” – Unaddressed Mental Health Needs and Self-Support Strategies in Medicaid-Funded Assisted Living

Jun 1, 2023
WHAT THIS MEANS FOR YOU: This study investigated mental health needs and barriers among residents at Medicaid-funded AL communities. At one AL community in the Bronx, 13 residents completed questionnaires and interviews; analysis revealed patterns of mental health needs, feelings of losing control, mistrust of organizational staff, and lack of resources and support.

“I Have a Lotta Sad Feelin'” – Unaddressed Mental Health Needs and Self-Support Strategies in Medicaid-Funded Assisted Living

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study investigated mental health needs and barriers among residents at Medicaid-funded AL communities. At one AL community in the Bronx, 13 residents completed questionnaires and interviews; analysis revealed patterns of mental health needs, feelings of losing control, mistrust of organizational staff, and lack of resources and support.

Attachment Behaviours in Adults with Intellectual Disabilities in Assisted Living Facilities: Representations from Direct-Care Staff

Jun 1, 2023
WHAT THIS MEANS FOR YOU: In this study, 19 support staff from 7 assisted living communities in Belgium were interviewed to understand about how adults with intellectual disabilities related to these staff. Themes revealed that staff often struggled finding a balance between supporting select attachment behaviors and maintaining a professional distance from residents to prevent negative impact on their work.

Attachment Behaviours in Adults with Intellectual Disabilities in Assisted Living Facilities: Representations from Direct-Care Staff

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: In this study, 19 support staff from 7 assisted living communities in Belgium were interviewed to understand about how adults with intellectual disabilities related to these staff. Themes revealed that staff often struggled finding a balance between supporting select attachment behaviors and maintaining a professional distance from residents to prevent negative impact on their work.

Likelihood of Assisted Living Residents Aging in Place as a Factor of Dual Medicare-Medicaid Eligibility at the End of Life

May 1, 2023
WHAT THIS MEANS FOR YOU: This study used Medicare enrollment and claims records to examine more than 142,000 AL residents’ ability to stay in their community in the last 30 days of life. Residents who were eligible for both Medicaid and Medicare (dual eligibles) were much less likely than those not eligible for Medicaid to remain in AL in their last 30 days of life or die there. However, this difference varies by state.

Likelihood of Assisted Living Residents Aging in Place as a Factor of Dual Medicare-Medicaid Eligibility at the End of Life

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study used Medicare enrollment and claims records to examine more than 142,000 AL residents’ ability to stay in their community in the last 30 days of life. Residents who were eligible for both Medicaid and Medicare (dual eligibles) were much less likely than those not eligible for Medicaid to remain in AL in their last 30 days of life or die there. However, this difference varies by state.

Fall Prevention Care Management: Implementation and Outcomes of a Project to Reduce Fall Risks of Older Adults in Assisted Living Facilities

May 1, 2023
WHAT THIS MEANS FOR YOU: In this study, undergraduate nursing students implemented a 6-week Fall Prevention Care Management intervention for 25 residents in two AL communities. The intervention included individualized care using motivational interviewing and behavioral change related to fall prevention, as well as helping residents reflect on their perceptions of fall prevention. Qualitative analysis suggested that individualized support improved residents’ opinions of the intervention and facilitated participation for residents at high risk of falls.

Fall Prevention Care Management: Implementation and Outcomes of a Project to Reduce Fall Risks of Older Adults in Assisted Living Facilities

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: In this study, undergraduate nursing students implemented a 6-week Fall Prevention Care Management intervention for 25 residents in two AL communities. The intervention included individualized care using motivational interviewing and behavioral change related to fall prevention, as well as helping residents reflect on their perceptions of fall prevention. Qualitative analysis suggested that individualized support improved residents’ opinions of the intervention and facilitated participation for residents at high risk of falls.

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

May 1, 2023
WHAT THIS MEANS FOR YOU: This study used Medicare and CDC datasets to examine telemedicine primary care among 62,000 AL residents with dementia during the first year of the COVID-19 pandemic (2020). During the first three quarters of the pandemic, racially minoritized groups (Black, Hispanic) and Medicare-Medicaid dual eligibles were able to successfully use telemedicine at high rates. Gaps in primary care access between these groups and others (white, non-Medicaid eligible) were reduced due to telemedicine. This could inform CMS decisions about Medicare coverage for telemedicine primary care.

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

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study used Medicare and CDC datasets to examine telemedicine primary care among 62,000 AL residents with dementia during the first year of the COVID-19 pandemic (2020). During the first three quarters of the pandemic, racially minoritized groups (Black, Hispanic) and Medicare-Medicaid dual eligibles were able to successfully use telemedicine at high rates. Gaps in primary care access between these groups and others (white, non-Medicaid eligible) were reduced due to telemedicine. This could inform CMS decisions about Medicare coverage for telemedicine primary care.

Identifying a National Cohort of Medicare Beneficiaries Residing in Assisted Living Settings: An Updated Method

May 1, 2023
WHAT THIS MEANS FOR YOU: A new methodology was developed for identifying Medicare beneficiaries residing in licensed AL communities in the US using zip code data, Medicare enrollment data, and claims data, and exclusion based on AL capacity (licensing information). Results suggested that using licensing information makes identifying AL residents receiving Medicare more accurate, which could inform research and policy by providing new insights into the health of AL residents.

Identifying a National Cohort of Medicare Beneficiaries Residing in Assisted Living Settings: An Updated Method

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: A new methodology was developed for identifying Medicare beneficiaries residing in licensed AL communities in the US using zip code data, Medicare enrollment data, and claims data, and exclusion based on AL capacity (licensing information). Results suggested that using licensing information makes identifying AL residents receiving Medicare more accurate, which could inform research and policy by providing new insights into the health of AL residents.

Grief, Social Support, Spirituality, and Depressive Symptoms Among Older Adults in Assisted Living in Kansas

May 1, 2023
WHAT THIS MEANS FOR YOU: In a study of 316 residents from seven assisted living communities in Kansas, higher grief related to more depressive symptoms, while strong support from friends and spiritual coping related to fewer symptoms. Thus, bereavement, social support, and spiritual intervention programs may potentially alleviate depression symptoms in assisted living residents.

Grief, Social Support, Spirituality, and Depressive Symptoms Among Older Adults in Assisted Living in Kansas

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: In a study of 316 residents from seven assisted living communities in Kansas, higher grief related to more depressive symptoms, while strong support from friends and spiritual coping related to fewer symptoms. Thus, bereavement, social support, and spiritual intervention programs may potentially alleviate depression symptoms in assisted living residents.