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

Date: December 2025Topics: Families/Caregivers, Quality Improvement, Staff/StaffingType: Academic PublicationPublication: Journal of the American Medical Directors AssociationAuthors: Cho, Y., Crowder, V., Dictus, C., Chiong, C. J., Bian, W., Wang, J., Hoben, M., Chamberlain, S., Anderson, R. A., Vogelsmeier, A., Lindsay, S., Baernholdt, M., Pam, D., Miller, S., Zou, B., & Beeber, A. S.
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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 and Participants: Data were collected from 104 participants in AL communities across the United States, comprising 32 residents, 34 family caregivers, and 38 staff members.

Methods: We conducted summative content analysis of interview transcripts, identifying distinct safety concerns and comparing the commonality and discrepancies in safety concerns across the 3 participant groups.

Results: We identified 29 safety concerns in AL communities. For the top common safety concern, resident condition-related falls were the most frequently reported concern across all groups. Regarding the discrepancies among the 3 groups, resident and/or family groups expressed concerns about prompt use of assistive devices and technology, communication/relationships, and self-care/independence, whereas staff frequently reported concern with environmental issues causing falls.

Conclusions and Implications: Safety concerns in AL communities are multifaceted and shared across residents, family caregivers, and staff, with falls and unmet care needs being primary concerns. However, differences identified in this study suggest the need for tailored interventions that address the unique concerns of each group. Improving communication among staff, residents, and families may reduce safety concern mismatches and potentially contribute to a safer AL environment.

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