The Maryland Assisted Living Study: Prevalence, Recognition, and Treatment of Dementia and Other Psychiatric Disorders in the Assisted Living Population of Central Maryland

Rosenblatt, Adam; Samus, Quincy M.; Steele, Cynthia D.; Baker, Alva; Harper, Michael; Brandt, Jason; Rabins, Peter V.; Lyketsos, Constantine G.

doi:10.1111/j.1532-5415.2004.52452.x

Cited by 131 publications

(142 citation statements)

References 27 publications

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“…6 Similarly, a systematic review of the structures and processes of care in nursing homes and other residential long-term settings found that residents who were in special care units in assisted living experienced more functional decline than those who were not. 7 To date, most of what is known about assisted living, and more specifically about residents with dementia in assisted living, has been obtained from studies involving a limited number of residences or using state 8 or multistate 9 samples instead of national samples. This study used national data, which recently became available, to describe the proportions and characteristics of assisted living residents with mild, moderate, and severe cognitive impairment; the characteristics of the residences in which they live; and the residences' dementia-related staffing and training, policies, and practices and costs for care.…”

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confidence: 99%

Dementia Prevalence And Care In Assisted Living

Zimmerman

Sloane²,

Reed³

2014

Health Affairs

201

149

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Assisted living residences have become prominent sites of longterm residential care for older adults with dementia. Estimates derived from national data indicate that seven out of ten residents in these residences have some form of cognitive impairment, with 29 percent having mild impairment, 23 percent moderate impairment, and 19 percent severe impairment. More than one-third of residents display behavioral symptoms, and of these, 57 percent have a medication prescribed for their symptoms. Only a minority of cognitively impaired residents reside in a dementia special care unit, where admission and discharge policies are more supportive of their needs. Policy-relevant recommendations from our study include the need to examine the use of psychotropic medications and cultures related to prescribing, better train assisted living staff to handle medications and provide nonpharmacological treatments, use best practices in caring for people with dementia, and promote consumer education regarding policies and practices in assisted living.

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confidence: 99%

Dementia Prevalence And Care In Assisted Living

Zimmerman

Sloane²,

Reed³

2014

Health Affairs

201

149

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“…Recent reports indicate that as many as 68% of AL residents have dementia, another 10% have cognitive impairments that are not classifiable as dementia, and 25% have other active psychiatric disturbances such as anxiety and depressive disorders (Rosenblatt et al, 2004). Behavioral and psychological symptoms that occur in 90% of older adults with dementia at some point during the course of their illness (Haupt, Kurz, & Janner, 2000) are reported to occur in more than half of AL residents .…”

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confidence: 99%

Dementia-Specific Assisted Living: Clinical Factors and Psychotropic Medication Use

Smith

Buckwalter

Kang

et al. 2008

J Am Psychiatr Nurses Assoc

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“…Because confusion, difficulty managing medications, and the need for help with basic and instrumental activities of daily living are key reasons for moving to assisted living, one can assume that dementia is somewhat more prevalent in assisted living than in the general population of the same age. We were therefore not surprised with the results of four recent studies, as shown in Table 1 ( ALFA, 2006;Rosenblatt et al, 2004;Sloane, Zimmerman, & Ory, 2001) that reported dementia prevalence in assisted living ranging from approximately 40% to 67%. These prevalence numbers aggregated assisted living residents living both in special units or buildings and those mixed in the general dementia population.…”

Section: Resident Characteristicsmentioning

confidence: 73%

“…Consequently, some of the health-care-related issues for the dementia population in this setting include security of medication storage for all residents; the management of as-needed medications, especially psychotropics (Rosenblatt et al, 2004); and the management of diabetes treatment. Medication undertreatment of medical conditions, such as congestive heart failure and osteoporosis, appears to be prevalent in RC/AL facilities .…”

Section: Health Care Provisionmentioning

confidence: 99%

Dementia and Assisted Living

Hyde¹,

Pérez²,

Forester³

2007

The Gerontologist

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Purpose: This article presents an overview of what is known about dementia services in assisted living settings and suggests areas for future research. Design and Methods: We undertook a search of Medline, the Journals of Gerontology, and The Gerontologist. We then organized publications dealing with the target subject into 10 topic areas and reviewed them. Results: The article describes the demographic characteristics of cognitively impaired residents in assisted living and related residential settings in the United States, the services they receive, and process and structural elements both in specialized dementia units and in integrated assisted living settings. Finally, we review the literature on methodological issues regarding research in this area. Implications: It is important to generate research on processes as well as outcomes, such as dignity, individualized and pleasurable experiences, and freedom from pain and discomfort. We make recommendations for both content areas that would benefit from further research as well as methodological approaches that will yield important information in this field.Key Words: Long-term care, Alzheimer's disease, Cognitively impaired, Aging in place, Residential careThis article outlines what is known about dementia services in assisted living settings and explores the many questions that remain unanswered. Ultimately, research is needed that will offer specific information regarding how assisted living processes and structure result in specific outcomes in the various subpopulations of cognitively impaired residents. The variability of assisted living and its philosophy of customizing services to the wishes and needs of each individual resident provide a rich environment for research as researchers attempt to discover what works best for whom (Feldman & Kane, 2003). We also discuss the range of processes and outcomes that one should consider in evaluating the effectiveness of assisted living services and environments, including the central role of quality of life in the assisted living philosophy of dementia care.Assisted living, as an industry, is less than 20 years old. Early research sought to enumerate how many people with dementia lived in assisted living, how many were in special care units (SCUs) or in general assisted living settings, and what kinds of services they received. However, even these simple facts have been elusive as basic data such as the prevalence of dementia can be difficult to determine in these non-health-care settings. In fact, determining which settings meet the criteria to be considered assisted living can, in itself, be less than straightforward.Central to the assisted living philosophy is a respect for the individuals who live in this setting and their continued rights as citizens and human beings. However, this philosophy is challenged when the people served have cognitive impairments that compromise their ability to make or communicate decisions regarding their care and lifestyle choices.Not all regulators, providers, family members, co...

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The Maryland Assisted Living Study: Prevalence, Recognition, and Treatment of Dementia and Other Psychiatric Disorders in the Assisted Living Population of Central Maryland

Abstract: Dementia and psychiatric disorders are common in AL and have suboptimal rates of recognition and treatment. This may contribute to morbidity and interfere with the ability of residents to age in place.

Cited by 131 publications

References 27 publications

Dementia Prevalence And Care In Assisted Living

Dementia Prevalence And Care In Assisted Living

Dementia-Specific Assisted Living: Clinical Factors and Psychotropic Medication Use

Dementia and Assisted Living

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