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Center for Excellence in Assisted Living

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.

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Academic Publication

Interprofessional care in a retirement and assisted living community: the complexity of teamwork

Apr 1, 2023
WHAT THIS MEANS FOR YOU: Face-to-face interviews with healthcare professionals, group meetings, and participant observation were used to examine interprofessional care teamwork in one community that combines independent living, AL, and skilled nursing. Organizational context, care setting factors, and reimbursement programs like Medicare and Medicaid affected teamwork in different ways; for example, co-location of services in a building did not necessarily ensure teamwork among care providers. Additionally, mission-driven investment in care was not sufficient to ensure teamwork. Thus, teamwork in communities that have different levels of care must be specifically considered when creating organizational policies and procedures.

Interprofessional care in a retirement and assisted living community: the complexity of teamwork

April 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Face-to-face interviews with healthcare professionals, group meetings, and participant observation were used to examine interprofessional care teamwork in one community that combines independent living, AL, and skilled nursing. Organizational context, care setting factors, and reimbursement programs like Medicare and Medicaid affected teamwork in different ways; for example, co-location of services in a building did not necessarily ensure teamwork among care providers. Additionally, mission-driven investment in care was not sufficient to ensure teamwork. Thus, teamwork in communities that have different levels of care must be specifically considered when creating organizational policies and procedures.

State Variation in Antipsychotic Use Among Assisted Living Residents With Dementia

Apr 1, 2023
WHAT THIS MEANS FOR YOU: This study of almost 21,000 AL residents in 2017 revealed that those with dementia were prescribed antipsychotics during about 13% of their time residing in AL. This proportion varied by state, with Hawaii having the lowest prescription rate (8%), and Wyoming having the highest (21%). Variations may be due to state regulation of AL communities, but the study was not able to determine if prescription practices were appropriate and tied to health outcomes.

State Variation in Antipsychotic Use Among Assisted Living Residents With Dementia

April 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study of almost 21,000 AL residents in 2017 revealed that those with dementia were prescribed antipsychotics during about 13% of their time residing in AL. This proportion varied by state, with Hawaii having the lowest prescription rate (8%), and Wyoming having the highest (21%). Variations may be due to state regulation of AL communities, but the study was not able to determine if prescription practices were appropriate and tied to health outcomes.

Caregiver Involvement and Concerns with Care of Residents of Assisted Living Before and During the COVID-19 Pandemic

Apr 1, 2023
WHAT THIS MEANS FOR YOU: A survey about AL family caregiver experiences in Western Canada was conducted before and during waves one (Mar to Jun 2020) and two (Oct 2020 to Feb 2021) of the COVID-19 pandemic. A total of 386 family caregivers representing 110 AL communities participated. In-person visits and caregiver involvement decreased significantly during wave one of the pandemic due to visitor restrictions. Caregivers’ concerns about their relatives significantly increased during both waves, especially when they did not feel well-informed or involved in their relative’s care.

Caregiver Involvement and Concerns with Care of Residents of Assisted Living Before and During the COVID-19 Pandemic

April 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: A survey about AL family caregiver experiences in Western Canada was conducted before and during waves one (Mar to Jun 2020) and two (Oct 2020 to Feb 2021) of the COVID-19 pandemic. A total of 386 family caregivers representing 110 AL communities participated. In-person visits and caregiver involvement decreased significantly during wave one of the pandemic due to visitor restrictions. Caregivers’ concerns about their relatives significantly increased during both waves, especially when they did not feel well-informed or involved in their relative’s care.

Experiences of Social Frailty Among Rural Community-Dwelling and Assisted-Living Older Adults: A Qualitative Study

Apr 1, 2023
WHAT THIS MEANS FOR YOU: Interviews were conducted with 38 older adults in rural villages and AL communities in the Netherlands to compare the effect of social frailty, measured by access to social resources and activities that fulfill social needs. Social frailty is the actual or potential loss of social resources and activities over time, leading to loneliness and isolation. Older adults who live independently in their own communities experienced self-reported loneliness, while those living in AL communities reported higher participation in social activities. Therefore, for some older adults, a residential setting may be preferable to aging in place to address loneliness and social frailty.

Experiences of Social Frailty Among Rural Community-Dwelling and Assisted-Living Older Adults: A Qualitative Study

April 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Interviews were conducted with 38 older adults in rural villages and AL communities in the Netherlands to compare the effect of social frailty, measured by access to social resources and activities that fulfill social needs. Social frailty is the actual or potential loss of social resources and activities over time, leading to loneliness and isolation. Older adults who live independently in their own communities experienced self-reported loneliness, while those living in AL communities reported higher participation in social activities. Therefore, for some older adults, a residential setting may be preferable to aging in place to address loneliness and social frailty.

Robots in Assisted Living Facilities: Scoping Review

Mar 1, 2023
WHAT THIS MEANS FOR YOU: There is a persisting staffing shortage in long-term care, and the use of robots in AL shows promise in relieving some staffing pressures. This systematic review found benefits of using robots to improve social interaction, emotional regulation, and fall prevention; however, some studies found barriers to robot use and inconclusive results. Overall, the quality of many of the studies was questionable, and more rigorous studies are needed to understand the impact of robots on AL staff and residents.

Robots in Assisted Living Facilities: Scoping Review

March 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: There is a persisting staffing shortage in long-term care, and the use of robots in AL shows promise in relieving some staffing pressures. This systematic review found benefits of using robots to improve social interaction, emotional regulation, and fall prevention; however, some studies found barriers to robot use and inconclusive results. Overall, the quality of many of the studies was questionable, and more rigorous studies are needed to understand the impact of robots on AL staff and residents.

Using Medicare Enrollment Data to Identify Beneficiaries in Assisted Living

Mar 1, 2023
WHAT THIS MEANS FOR YOU: Because AL is state-regulated, obtaining information about Medicare beneficiaries in AL can be difficult. This study identified AL Medicare beneficiaries using zip code files, Medicare databases, and other data sets, which can aid researchers and policymakers.

Using Medicare Enrollment Data to Identify Beneficiaries in Assisted Living

March 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Because AL is state-regulated, obtaining information about Medicare beneficiaries in AL can be difficult. This study identified AL Medicare beneficiaries using zip code files, Medicare databases, and other data sets, which can aid researchers and policymakers.

Digital Immunization Tracking in Long-Term Care and Assisted Living Facilities

Feb 1, 2023
WHAT THIS MEANS FOR YOU: Vaccines are a part of the solution to infectious disease outbreaks like COVID-19, but not everyone is getting them, especially older adults. In a Canadian study, pneumonia vaccine uptake was improved by providing assisted living and long-term care communities with vaccine coverage data and providing automatic reminders for subsequent doses. Therefore, a cloud-based digital vaccination record is one solution to promote the uptake of adult vaccines for older adults, as well as tracking immunization records and sharing them with policymaking organizations. This can improve communication and inform policymakers to reduce the risk of infection in AL communities.

Digital Immunization Tracking in Long-Term Care and Assisted Living Facilities

February 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Vaccines are a part of the solution to infectious disease outbreaks like COVID-19, but not everyone is getting them, especially older adults. In a Canadian study, pneumonia vaccine uptake was improved by providing assisted living and long-term care communities with vaccine coverage data and providing automatic reminders for subsequent doses. Therefore, a cloud-based digital vaccination record is one solution to promote the uptake of adult vaccines for older adults, as well as tracking immunization records and sharing them with policymaking organizations. This can improve communication and inform policymakers to reduce the risk of infection in AL communities.

Physical Activity Programming for Older Adults in Assisted Living: Residents’ Perspectives

Feb 1, 2023
WHAT THIS MEANS FOR YOU: In a study gathering recommendations from AL residents about a program to increase physical activity. most residents were interested in increasing their activity and thought of it as being important. However, they had concerns about the program’s level of difficulty, the length of sessions, and how the end goals were framed. Thus, it is vital to elicit feedback from residents when designing a new program in AL.

Physical Activity Programming for Older Adults in Assisted Living: Residents’ Perspectives

February 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: In a study gathering recommendations from AL residents about a program to increase physical activity. most residents were interested in increasing their activity and thought of it as being important. However, they had concerns about the program’s level of difficulty, the length of sessions, and how the end goals were framed. Thus, it is vital to elicit feedback from residents when designing a new program in AL.

Association of Medicaid Financing and Concentration of Assisted Living Residents Dually Eligible for Medicare and Medicaid

Feb 1, 2023
WHAT THIS MEANS FOR YOU: About 25% of Medicare beneficiaries in AL are also eligible for Medicaid, 78% of whom lived in 20% of AL communities nationally. This study analyzed 47 state policies, 5 of which had no Medicaid coverage for AL services (put abbreviations of the five states here). However, those states had the highest concentration of Medicaid-eligible people residing in AL, meaning that Medicaid coverage in those 5 states could benefit many residents.

Association of Medicaid Financing and Concentration of Assisted Living Residents Dually Eligible for Medicare and Medicaid

February 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: About 25% of Medicare beneficiaries in AL are also eligible for Medicaid, 78% of whom lived in 20% of AL communities nationally. This study analyzed 47 state policies, 5 of which had no Medicaid coverage for AL services (put abbreviations of the five states here). However, those states had the highest concentration of Medicaid-eligible people residing in AL, meaning that Medicaid coverage in those 5 states could benefit many residents.

Feasibility of the Palliative Care Education in Assisted Living Intervention for Dementia Care Providers: A Cluster Randomized Trial

Feb 1, 2023
WHAT THIS MEANS FOR YOU: A study in Florida assessed a staff education intervention in 10 different AL communities, in which 118 AL residents with dementia participated. The intervention focused on person-centered palliative care for residents with dementia. It showed initial positive results by increasing palliative care practices, specifically advance care planning discussions and hospice admissions.

Feasibility of the Palliative Care Education in Assisted Living Intervention for Dementia Care Providers: A Cluster Randomized Trial

February 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: A study in Florida assessed a staff education intervention in 10 different AL communities, in which 118 AL residents with dementia participated. The intervention focused on person-centered palliative care for residents with dementia. It showed initial positive results by increasing palliative care practices, specifically advance care planning discussions and hospice admissions.

Well-being of professional older adults’ caregivers in Alberta’s assisted living and long-term care facilities: a cross-sectional study

Feb 1, 2023
WHAT THIS MEANS FOR YOU: A study in AL and other long-term care communities in Alberta assessed nurses’ and professional care aides’ physical, mental, and emotional health, behavior, stress, quality of life, turnover, and absenteeism. Mental and emotional health, quality of life, and stress related to turnover and absenteeism. Although 68% of caregivers reported being satisfied with their general health, they experienced heavy workloads and high stress. These issues may result in decreased job satisfaction, absenteeism, and higher turnover.

Well-being of professional older adults’ caregivers in Alberta’s assisted living and long-term care facilities: a cross-sectional study

February 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: A study in AL and other long-term care communities in Alberta assessed nurses’ and professional care aides’ physical, mental, and emotional health, behavior, stress, quality of life, turnover, and absenteeism. Mental and emotional health, quality of life, and stress related to turnover and absenteeism. Although 68% of caregivers reported being satisfied with their general health, they experienced heavy workloads and high stress. These issues may result in decreased job satisfaction, absenteeism, and higher turnover.

Preparedness and Response of Assisted Living Facilities Toward COVID-19 Infection Control in Houston, Texas, USA

Feb 1, 2023
WHAT THIS MEANS FOR YOU: The Houston Health Department conducted onsite assessments at AL communities to assess infection prevention and control practices. Larger AL communities better implemented CDC guidelines and were more proactive in their COVID-19 response activities. For example, many medium and small communities lacked access to COVID-19 PCR testing and had lower resident vaccination rates.

Preparedness and Response of Assisted Living Facilities Toward COVID-19 Infection Control in Houston, Texas, USA

February 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: The Houston Health Department conducted onsite assessments at AL communities to assess infection prevention and control practices. Larger AL communities better implemented CDC guidelines and were more proactive in their COVID-19 response activities. For example, many medium and small communities lacked access to COVID-19 PCR testing and had lower resident vaccination rates.

Medication Costs and Use of Older Americans in Assisted Living Settings: A Nationally Representative Cross-Sectional Study

Feb 1, 2023
WHAT THIS MEANS FOR YOU: Using data from 5,900 2015 National Health and Aging Trends Study participants aged 65 and above who had Medicare Part D prescription coverage, assisted living residents’ medication costs were twice as high as community-dwelling counterparts. Even though assisted living residents filled slightly fewer prescriptions than nursing home residents, they had similar rates of polypharmacy (10 or more prescriptions) and psychotropic medication prescriptions.

Medication Costs and Use of Older Americans in Assisted Living Settings: A Nationally Representative Cross-Sectional Study

February 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Using data from 5,900 2015 National Health and Aging Trends Study participants aged 65 and above who had Medicare Part D prescription coverage, assisted living residents’ medication costs were twice as high as community-dwelling counterparts. Even though assisted living residents filled slightly fewer prescriptions than nursing home residents, they had similar rates of polypharmacy (10 or more prescriptions) and psychotropic medication prescriptions.

Feasibility study of student-led fall prevention care management: Reducing fall risks in assisted living facilities

Jan 1, 2023
WHAT THIS MEANS FOR YOU: In two AL communities, twenty-five adults over the age of 65 or who fell in the previous year evaluated a student-led Fall Prevention Care Management (FPCM) program. Despite some positive outcomes (improved fall prevention behaviors and reduced fear of falling), there were some limitations, including disinterest in fall prevention from some participants. However, participants rated the program highly, meaning student-run fall prevention programs may be effective for some AL residents.

Feasibility study of student-led fall prevention care management: Reducing fall risks in assisted living facilities

January 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: In two AL communities, twenty-five adults over the age of 65 or who fell in the previous year evaluated a student-led Fall Prevention Care Management (FPCM) program. Despite some positive outcomes (improved fall prevention behaviors and reduced fear of falling), there were some limitations, including disinterest in fall prevention from some participants. However, participants rated the program highly, meaning student-run fall prevention programs may be effective for some AL residents.

Implementation of an Emergency Power Rule: Compliance of Florida Nursing Homes and Assisted Living Facilities

Jan 1, 2023
WHAT THIS MEANS FOR YOU: Data from 680 nursing homes (NHs) and 2940 AL communities in Florida examined compliance with an emergency power rule to have a secondary power source. The rule had higher implementation rates in AL than NH. AL communities were more likely to implement the new policy if they were smaller, did not offer memory care, accepted Medicaid, and had a mental health specialty license. Therefore, organizational characteristics and policies may help or hinder implementing new regulations.

Implementation of an Emergency Power Rule: Compliance of Florida Nursing Homes and Assisted Living Facilities

January 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Data from 680 nursing homes (NHs) and 2940 AL communities in Florida examined compliance with an emergency power rule to have a secondary power source. The rule had higher implementation rates in AL than NH. AL communities were more likely to implement the new policy if they were smaller, did not offer memory care, accepted Medicaid, and had a mental health specialty license. Therefore, organizational characteristics and policies may help or hinder implementing new regulations.

Now You’re Tax‐Exempt, Now You’re Not: Property Taxation of Assisted Living Facilities

Jan 1, 2023
WHAT THIS MEANS FOR YOU: Nonprofit AL communities in Florida lost their tax-exempt status in 2006 and regained it in 2017. Even when nonprofit AL communities had to pay property taxes, they provided higher-quality services than for-profit communities: more nursing staff, residents, and variety in care. In contrast, for-profit AL communities had more substantiated complaints and deficiencies, faced more sanctions after inspections, and incurred higher fines on average.

Now You’re Tax‐Exempt, Now You’re Not: Property Taxation of Assisted Living Facilities

January 1, 2023 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Nonprofit AL communities in Florida lost their tax-exempt status in 2006 and regained it in 2017. Even when nonprofit AL communities had to pay property taxes, they provided higher-quality services than for-profit communities: more nursing staff, residents, and variety in care. In contrast, for-profit AL communities had more substantiated complaints and deficiencies, faced more sanctions after inspections, and incurred higher fines on average.

“You Gotta Have Your Cry”: Administrator and Direct Care Worker Experiences of Death in Assisted Living

Dec 1, 2022
WHAT THIS MEANS FOR YOU: Qualitative data from 27 administrators and 38 direct care workers in 7 assisted living communities found that when residents died, staff members balanced their personal feelings about death and their work role in a process called “managing the normalization of death” with varying levels of perceived success. Additional resources and training about managing resident death, including improved collaboration with hospice services and clearer end-of-life care policies, might be helpful for staff.

“You Gotta Have Your Cry”: Administrator and Direct Care Worker Experiences of Death in Assisted Living

December 1, 2022 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Qualitative data from 27 administrators and 38 direct care workers in 7 assisted living communities found that when residents died, staff members balanced their personal feelings about death and their work role in a process called “managing the normalization of death” with varying levels of perceived success. Additional resources and training about managing resident death, including improved collaboration with hospice services and clearer end-of-life care policies, might be helpful for staff.

Are Online Reviews of Assisted Living Communities Associated with Patient-Centered Outcomes?

Dec 1, 2022
WHAT THIS MEANS FOR YOU: Findings from this study suggest that AL's online reviews may signal quality of care issues, offering consumers information to make more informed decisions in their AL selection, and that reviews may offer insight into residents' perspectives. However, ratings should not replace, but rather complement, other traditional ways of assessing resident experiences because of rating system limitations. Additionally, ratings may assist providers in making improvements to their ALs based on resident feedback, and function as a data source for policymakers about AL quality of care.

Are Online Reviews of Assisted Living Communities Associated with Patient-Centered Outcomes?

December 1, 2022 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Findings from this study suggest that AL’s online reviews may signal quality of care issues, offering consumers information to make more informed decisions in their AL selection, and that reviews may offer insight into residents’ perspectives. However, ratings should not replace, but rather complement, other traditional ways of assessing resident experiences because of rating system limitations. Additionally, ratings may assist providers in making improvements to their ALs based on resident feedback, and function as a data source for policymakers about AL quality of care.

Injury-Related Emergency Department Use among Assisted Living Residents with Alzheimer’s Disease and Related Dementias

Dec 1, 2022
WHAT THIS MEANS FOR YOU: Using 2018 Medicare data for over 116,000 residents, residents with dementia had a 25% higher risk of going to the emergency room for injuries compared to those without dementia, as well as having a significantly higher chance of being hospitalized for injuries, regardless of whether they lived in general assisted living or memory care.

Injury-Related Emergency Department Use among Assisted Living Residents with Alzheimer’s Disease and Related Dementias

December 1, 2022 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Using 2018 Medicare data for over 116,000 residents, residents with dementia had a 25% higher risk of going to the emergency room for injuries compared to those without dementia, as well as having a significantly higher chance of being hospitalized for injuries, regardless of whether they lived in general assisted living or memory care.

Psychotropic Medication Prescribing in Assisted Living and Nursing Home Residents with Dementia after the National Partnership

Dec 1, 2022
WHAT THIS MEANS FOR YOU: Using Medicare data for over 430,000 assisted living and long-stay nursing home residents, prescriptions for antipsychotic drugs decreased in both settings from 2010-2012 (before the National Partnership to Improve Dementia Care in Nursing Homes) to 2012-2017 (post-Partnership). However, assisted living prescribing decreased at a slower rate than nursing homes, meaning that the Partnership likely did not have a measurable impact in assisted living.

Psychotropic Medication Prescribing in Assisted Living and Nursing Home Residents with Dementia after the National Partnership

December 1, 2022 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Using Medicare data for over 430,000 assisted living and long-stay nursing home residents, prescriptions for antipsychotic drugs decreased in both settings from 2010-2012 (before the National Partnership to Improve Dementia Care in Nursing Homes) to 2012-2017 (post-Partnership). However, assisted living prescribing decreased at a slower rate than nursing homes, meaning that the Partnership likely did not have a measurable impact in assisted living.

Coping Behaviors and Health Status during the COVID-19 Pandemic among Caregivers of Assisted Living Residents in Western Canada

Dec 1, 2022
WHAT THIS MEANS FOR YOU: Surveys from 673 assisted living direct caregivers revealed that coping behaviors such as alcohol and smoking/cannabis use, and psychotropic drug use increased during the first two waves of the COVID-19 pandemic and were more common among caregivers who had anxiety or depression symptoms before the pandemic. These caregivers are thus particularly vulnerable to negative coping behaviors during stressful events and may require additional support.

Coping Behaviors and Health Status during the COVID-19 Pandemic among Caregivers of Assisted Living Residents in Western Canada

December 1, 2022 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Surveys from 673 assisted living direct caregivers revealed that coping behaviors such as alcohol and smoking/cannabis use, and psychotropic drug use increased during the first two waves of the COVID-19 pandemic and were more common among caregivers who had anxiety or depression symptoms before the pandemic. These caregivers are thus particularly vulnerable to negative coping behaviors during stressful events and may require additional support.

Patient Safety Culture in Assisted Living: Staff Perceptions and Association with State Regulations

Dec 1, 2022
WHAT THIS MEANS FOR YOU: A total of 714 administrators and direct care workers in 257 assisted living communities reported that direct care workers had a more negative perception of patient safety culture (PSC) than administrators. Stricter state regulations, particularly regarding staffing, were associated with better perceptions of PSC among direct care workers.

Patient Safety Culture in Assisted Living: Staff Perceptions and Association with State Regulations

December 1, 2022 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: A total of 714 administrators and direct care workers in 257 assisted living communities reported that direct care workers had a more negative perception of patient safety culture (PSC) than administrators. Stricter state regulations, particularly regarding staffing, were associated with better perceptions of PSC among direct care workers.

Association between State Regulations Supportive of Third-Party Services and Likelihood of Assisted Living Residents in the US Dying in Place

Oct 1, 2022
WHAT THIS MEANS FOR YOU: Medicare data from nearly 170,000 residents from over 8,000 assisted communities with more than 25 beds who died between 2017 and 2019 indicated that in states with regulations supportive of third-party hospice services, residents were significantly more likely to die in assisted living than in a hospital or nursing home.

Association between State Regulations Supportive of Third-Party Services and Likelihood of Assisted Living Residents in the US Dying in Place

October 1, 2022 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Medicare data from nearly 170,000 residents from over 8,000 assisted communities with more than 25 beds who died between 2017 and 2019 indicated that in states with regulations supportive of third-party hospice services, residents were significantly more likely to die in assisted living than in a hospital or nursing home.

Excess Mortality Among Assisted Living Residents with Dementia during the COVID-19 Pandemic

Oct 1, 2022
WHAT THIS MEANS FOR YOU: Data from over 560,000 Medicare recipients revealed that residents with dementia experienced 33.4 more excess deaths per 100,000 compared to those without dementia during the COVID-19 pandemic. Residents in memory care communities did not have significantly different mortality rates compared to those in general assisted living settings.

Excess Mortality Among Assisted Living Residents with Dementia during the COVID-19 Pandemic

October 1, 2022 by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Data from over 560,000 Medicare recipients revealed that residents with dementia experienced 33.4 more excess deaths per 100,000 compared to those without dementia during the COVID-19 pandemic. Residents in memory care communities did not have significantly different mortality rates compared to those in general assisted living settings.

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