The Impact of Enhanced Programming on Aging in Place for People With Dementia in Assisted Living

Hyde, Joan; Pérez, Rosa; Doyle, Patrick J.; Forester, Brent P.; Whitfield, Theodore H.

doi:10.1177/1533317513520212

Cited by 7 publications

(5 citation statements)

References 14 publications

(13 reference statements)

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“…As a dementia care program is the least prevalent regulated care service offered in assisted living facilities in Ontario, we hypothesize assisted living facilities that offer a dementia care program have an array of care services to support aging in place among residents. Our hypothesis is supported by other studies that investigated enhanced programming and special care units for dementia in assisted living facilities [ 23 , 24 ].…”

Section: Introductionsupporting

confidence: 86%

Do assisted living facilities that offer a dementia care program differ from those that do not? A population-level cross-sectional study in Ontario, Canada

et al. 2021

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Background Many residents of assisted living facilities live with dementia, but little is known about the characteristics of assisted living facilities that provide specialized care for older adults who live with dementia. In this study, we identify the characteristics of assisted living facilities that offer a dementia care program, compared to those that do not offer such a program. Methods We conducted a population-level cross-sectional study on all licensed assisted living facilities in Ontario, Canada in 2018 (n = 738). Facility-level characteristics (e.g., resident and suite capacities, etc.) and the provision of the other 12 provincially regulated care services (e.g., pharmacist and medical services, skin and wound care, etc.) attributed to assisted living facilities were examined. Multivariable Poisson regression with robust standard errors was used to model the characteristics of assisted living facilities associated with the provision of a dementia care program. Results There were 123 assisted living facilities that offered a dementia care program (16.7% versus 83.3% no dementia care). Nearly half of these facilities had a resident capacity exceeding 140 older adults (44.7% versus 21.6% no dementia care) and more than 115 suites (46.3% versus 20.8% no dementia care). All assisted living facilities that offered a dementia care program also offered nursing services, meals, assistance with bathing and hygiene, and administered medications. After adjustment for facility characteristics and other provincially regulated care services, the prevalence of a dementia care program was nearly three times greater in assisted living facilities that offered assistance with feeding (Prevalence Ratio [PR] 2.91, 95% Confidence Interval [CI] 1.98 to 4.29), and almost twice as great among assisted living facilities that offered medical services (PR 1.78, 95% CI 1.00 to 3.17), compared to those that did not. Conclusions A dementia care program was more prevalent in assisted living facilities that housed many older adults, had many suites, and offered at least five of the other 12 regulated care services. Our findings deepen the understanding of specialized care for dementia in assisted living facilities.

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Section: Introductionsupporting

confidence: 86%

Do assisted living facilities that offer a dementia care program differ from those that do not? A population-level cross-sectional study in Ontario, Canada

et al. 2021

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“…6 Research also suggests that some families are concerned about the safety of their loved ones in RC/AL, and their receiving suitable care by properly trained staff. 7 While evidence shows it is possible to provide adequate EOL services in RC/AL with a robust staff training program 8 and relationships with hospice providers, increasing demand for dying in place 1,2 calls for a systematic assessment of facility practices surrounding EOL care in RC/AL. 9…”

Section: Introductionmentioning

confidence: 99%

Organizational Characteristics of Assisted Living Communities With Policies Supportive of Admitting and Retaining Residents in Need of End-of-Life Care

Travis

Thomas

Clark

et al. 2020

Am J Hosp Palliat Care

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Background: There has been a rapid increase in the number of residential care/assisted living communities (RC/AL) that allow residents to die in place. The objective of this study was to examine the organizational characteristics of RC/AL communities that are associated with facility-level policies supportive of admitting and retaining residents in need of end-of-life (EOL) care. Methods : We used cross-sectional data from the 2010 National Survey of Residential Care Facilities. Organizational characteristics included structural factors, staffing levels, and other relevant facility-level policies. We examined descriptive statistics, binomial and multivariable multinomial regression models to determine the likelihood of 1) admitting and retaining, or 2) only retaining, as compared to 3) neither admitting nor retaining AL residents in need of EOL care. Results: A majority of residential care facilities 73.7% (n = 22,642) reported admitting and retaining residents at EOL. Yet, levels of skilled nursing care were generally low with 60.9% of these RC/AL communities reporting that registered nurses were not available, including hospice staff. In multivariable, multinomial regression models, organizational characteristics such as skilled nursing, hands-on contact hours from personal care aides, and policies allowing exemptions to self-evacuation rules were associated with increased likelihood of RC/AL communities admitting/retaining residents in need of EOL care. Conclusion: Despite overall low levels of skilled nursing care, a nationally representative survey revealed that a majority of RC/AL communities admit and retain residents in need of EOL care. Staffing and exemptions from self-evacuation policies appear to be central characteristics associated with the provision of these services in RC/AL communities.

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“…6 Researchers also found significantly longer LOS to be associated with the utilization of an aging in place model coupled with a willingness to provide palliative care. 9…”

Section: Introductionmentioning

confidence: 99%

“…6 Researchers also found significantly longer LOS to be associated with the utilization of an aging in place model coupled with a willingness to provide palliative care. 9 Many persons with dementia will ultimately face nursing home placement, which adds significant stress on the person with dementia as well as family members. 10 Depression, agitation, decreasing cognition, frailty, and falls in people with dementia are factors most highly linked to nursing home placement.…”

Section: Introductionmentioning

confidence: 99%

Marital Status and Persons With Dementia in Assisted Living

Fields

Richardson

Schuman

2017

Am J Alzheimers Dis Other Demen

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Despite the prevalence of dementia among residents in assisted living (AL), few researchers have focused on the length of stay (LOS) in AL among this population. Little is known about the factors that may contribute to LOS in these settings, particularly for residents with dementia. In the current study, a sub-set of AL residents with dementia (n = 112) was utilized to examine whether marital status was associated with LOS in AL as this has received sparse attention in previous research despite studies suggesting that marital status influences LOS in other health-care and long-term care settings. The Andersen-Newman behavioral model was used as a conceptual framework for the basis of this study of LOS, marital status, and dementia in AL. We hypothesized that persons with dementia who were married would have longer LOS than unmarried persons with dementia in AL. Cox regression was used to examine the association between marital status and LOS in AL of residents with dementia and whether activities of daily living were related to discharge from AL settings among married and unmarried residents with dementia. Main effects for marital status and the interaction between marital status and mobility with LOS were examined. Study findings provide information related to the psychosocial needs of AL residents with dementia and offer implications for assessing the on-going needs of vulnerable AL residents.

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The Impact of Enhanced Programming on Aging in Place for People With Dementia in Assisted Living

Abstract: AL sites with a more robust commitment to an aging in place model and a willingness to provide palliative care demonstrated a significantly longer length of stay.

Cited by 7 publications

References 14 publications

Do assisted living facilities that offer a dementia care program differ from those that do not? A population-level cross-sectional study in Ontario, Canada

Do assisted living facilities that offer a dementia care program differ from those that do not? A population-level cross-sectional study in Ontario, Canada

Organizational Characteristics of Assisted Living Communities With Policies Supportive of Admitting and Retaining Residents in Need of End-of-Life Care

Marital Status and Persons With Dementia in Assisted Living

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