scholarly journals INTEREST GROUP SESSION—ASSISTED LIVING: DEMENTIA IN ASSISTED LIVING: STATE VARIABILITY IN REGULATIONS, OVERSIGHT, AND RESIDENT OUTCOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S545-S545
Author(s):  
Kali S Thomas ◽  
Lindsay Schwartz
Keyword(s):  
Assisted Living ◽  
Organizational Leaders ◽  
Term Care ◽  
Policy Makers ◽  
Optimal Outcomes ◽  
Current State ◽  
Regulatory Decisions ◽  
Discharge Criteria

Abstract Approximately one million individuals, an estimated 40% with a diagnosis of Alzheimer’s disease-related dementias (ADRD), reside in assisted living (AL); yet, little is known about their experience or the quality of care provided in AL. Unlike other forms of long-term care (LTC), the licensing, operating, and enforcement requirements for AL falls to the states, which vary dramatically in their regulatory approaches. The overall objective of this symposium is to examine states’ AL regulatory environments and understand if and how the health outcomes of AL residents with ADRD are impacted by states’ regulatory decisions. Presenters will highlight the state variability in the regulation, oversight, resident composition, and outcomes of AL residents with ADRD. The first presentation will describe states’ different regulatory requirements for staffing and admission/discharge criteria as it relates to residents with ADRD and how those have changed over the last decade. The second presentation will report results from a national survey of state agents regarding their oversight and enforcement activities in AL. The third presentation will characterize differences in the resident composition and healthcare utilization among residents with ADRD across states. The fourth presenter will report on the effect of residing in an AL licensed to provide specialized dementia care versus a standard-licensed AL on ADRD residents’ outcomes. The discussant will contextualize findings as they relate to the current state of the AL industry. Results will ultimately inform policy-makers, organizational leaders, and clinicians as they seek the most effective ways to ensure optimal outcomes vulnerable residents with ADRD.

scholarly journals State Variability in Assisted Living Regulations, Access, and Outcomes for Persons With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 715-715
Author(s):  
Kali Thomas
Keyword(s):  
Assisted Living ◽  
Dementia Care ◽  
Emergency Department Utilization ◽  
Organizational Leaders ◽  
Term Care ◽  
Policy Makers ◽  
Optimal Outcomes ◽  
Staffing Requirements ◽  
Regulatory Decisions

Abstract Approximately one million individuals, an estimated40% with a diagnosis of Alzheimer’s disease-related dementias (ADRD), reside in assisted living (AL); yet, little is known about their experience or the quality of care provided in AL. Unlike other forms of long-term care (LTC), the licensing, operating, and enforcement requirements for AL falls to the states, which vary dramatically in their regulatory approaches. The overall objective of this symposium is to examine states’ AL regulatory environments and understand if and how access to AL and the health outcomes of AL residents with ADRD are impacted by states’ regulatory decisions. Presenters will highlight the state variability in the regulation, access, and outcomes of AL residents with ADRD. The first presentation will describe the within and between state differences in regulatory approaches as it relates to dementia care. The second presentation will describe the variation in Medicaid financing of services in AL and its potential impact on access to AL within those states. The third will present geographic disparities in access to specialized dementia care in AL. The fourth presentation will characterize differences in emergency department utilization among AL residents with ADRD across states. Finally, the fifth presenter will report on the effect of establishing or increasing state staffing requirements on outcomes of AL residents with ADRD. Results will ultimately inform policy-makers, organizational leaders, and clinicians as they seek the most effective ways to ensure equal access to AL and optimal outcomes for residents with ADRD. Assisted Living Interest Group Sponsored Symposium.

Ethical Considerations in the Conduct of Electronic Surveillance Research

2006 ◽  
Vol 34 (3) ◽  
pp. 611-619 ◽  
Author(s):  
Ashok J. Bharucha ◽  
Alex John London ◽  
David Barnard ◽  
Howard Wactlar ◽  
Mary Amanda Dew ◽  
...  
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
The United States ◽  
Assisted Living Facilities ◽  
Ethical Considerations ◽  
Term Care ◽  
Baby Boomer Generation ◽  
Demographic Shifts

Nearly 2.5 million Americans currently reside in nursing homes and assisted living facilities in the United States, accounting for approximately five percent of persons sixty-five and older. The aging of the “Baby Boomer” generation is expected to lead to an exponential growth in the need for some form of long-term care (LTC) for this segment of the population within the next twenty-five years. In light of these sobering demographic shifts, there is an urgency to address the profound concerns that exist about the quality-of-care (QoC) and quality-of-life (QoL) of this frailest segment of our population.

scholarly journals Satisfaction With Outdoor Activities Over Time Among Long-Term Services and Supports Recipients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 189-190
Author(s):  
Justine Sefcik ◽  
Karen Hirschman ◽  
Darina Petrovsky ◽  
Liming Huang ◽  
Nancy Hodgson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Assisted Living ◽  
Term Care ◽  
Chronic Health ◽  
Outdoor Activities ◽  
Services And Supports ◽  
Over Time

Abstract Approximately 85% of older adults have at least one chronic health condition. The onset of chronic health conditions and mobility issues can constrain activities, including outdoor recreation. There is limited knowledge of older adults receiving long-term services and supports (LTSS) and their satisfaction with outdoor activities over time after enrolling in services. This study examined predictors of change in ratings of satisfaction with outdoor activities. A secondary analysis was conducted of data involving structured interviews with older adults (N=470) over the first two years of receiving LTSS (Health-Related Quality of Life: Elders in Long-Term Care; R01AG025524). Participants lived in assisted living communities, nursing homes, or their home. A single item on satisfaction with outdoor activities (assessed using a 5-point Likert scale: not at all to extremely satisfied) was the primary outcome. Mixed effects linear regression modeling using a backward elimination process was used for building a final multivariable model. In the final model, older age (p<0.001) and higher overall quality of life ratings (p<0.001) at baseline were associated with slower rates of increase in outdoor satisfaction over time. Higher education level (p=0.035) at baseline was associated with a faster rate of increase in outdoor satisfaction over time. Additionally, those who moved into an assisted living community (p=0.024) or nursing home (p=0.016) at baseline were associated with faster rates of increase in outdoor satisfaction over time compared to those in the home. Knowledge of factors influencing satisfaction with outdoor activities can assist interdisciplinary teams implement interventions for individual or organizational changes.

scholarly journals Leveraging Promising Policies to Support Long-Term Care Residents' Quality of Life Post-Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 369-370
Author(s):  
Deanne Taylor ◽  
Janice Keefe ◽  
Heather Cook
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Lessons Learned ◽  
Term Care ◽  
Policy Language ◽  
Policy Makers ◽  
Pandemic Planning ◽  
Health Decision

Abstract Long-term care (LTC) is highly regulated and often the policy language is complex and in tension with residents’ quality of life goals. Prior to COVID-19, LTC policy levers prioritized safety over other quality domains such as privacy, dignity, spirituality, and comfort. During the pandemic, this focus on safety regulations, while important, intensified in ways that often negatively impacted residents’ overall quality of life. In this symposium, we share findings from a five- year research project where we conducted a unique and expansive review of regulatory policy across four Canadian jurisdictions. We highlight how 11 different quality of life domains are supported and which texts offering promising policy language to enhance a well-rounded quality of life for residents. These are timely insights to offer as policy-makers look to the future and consider the lessons learned from the pandemic. We contend that creating more LTC policy is not a timely pathway forward to LTC reform. Instead, we suggest that existing policy can be leveraged when applied within a resident-centred quality of life lens. We will guide attendees through examples of existing promising policies highlighting how they might leveraged in planning for a better LTC system. The discussion will be rooted in our unique resident-centred approach to policy analysis using specific domains of quality of life and then applied to four different perspectives: residents, families, staff and volunteers. Our discussant a Ministry of Health decision-maker will address the implications of our research for post-pandemic planning to improve resident quality of life

Improving Quality of Life in Long-Term Care

2009 ◽  
Vol 14 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Margaret P. Calkins ◽  
Jennifer Brush
Keyword(s):  
Quality Of Life ◽  
Nursing Homes ◽  
Assisted Living ◽  
Staff Training ◽  
Long Term Care ◽  
Assisted Living Facilities ◽  
Term Care ◽  
Management Structure

Abstract The entire field of long-term care is under tremendous pressure to change. Traditional environmental approaches based on staff-centric or medical models are no longer considered appropriate in long-term care settings. The new emphasis is on person-centered or self-directed care. This is reflected in settings where people can live comfortably and feel at home, as opposed to feeling like they are in a hospital. Increasingly, nursing homes are working to be more like assisted living facilities, which emphasize privacy, dignity, and choice. These changes affect all aspects of care from structure of governance to staff training to management structure and facility design. This article will cover the issues and the possible solutions to ensuring that long-term care living is more like a home than a hospital.

Adults: Group Care

2013 ◽  
Author(s):  
Robin Bonifas
Keyword(s):  
Family Involvement ◽  
Assisted Living ◽  
Long Term Care ◽  
Psychosocial Care ◽  
Care Needs ◽  
Term Care ◽  
Group Settings ◽  
Residential Long Term Care

This article presents information about group settings that provide residential long-term care for older adults, focusing on nursing homes and residential care/assisted living communities. It provides an overview of both settings and describes their scope of services, funding, and clientele. The section “Issues in Residential Long-Term Care” addresses issues of special relevance to social workers: dementia and other psychosocial care needs; quality of life and quality of care; access to and disparities in care; end-of-life care; family involvement; and abuse and neglect. The article ends with a section on the role of the social worker in residential long-term care.

scholarly journals THE IMPORTANCE OF THE LONG-TERM CARE WORKFORCE ON QUALITY OUTCOMES FOR INDIVIDUALS RECEIVING SERVICES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S440-S441
Author(s):  
Lindsay Schwartz ◽  
Howard Degenholtz ◽  
Amy M York
Keyword(s):  
Assisted Living ◽  
Health Care Professionals ◽  
Long Term Care ◽  
Supply And Demand ◽  
Direct Care ◽  
Quality Outcomes ◽  
Term Care ◽  
Demand Models

Abstract A strong, supported long-term care (LTC) workforce is vital to quality outcomes of individuals receiving LTC. With the sector facing issues around recruitment and retention, it is important to understand factors impacting the workforce. This symposium includes four presentations, a mix of both quantitative and qualitative research. First, Scales and colleagues will provide an overview of the workforce crisis using extensive policy analysis of home and community-based services (HCBS) in the US. Factors impacting the HCBS direct care workforce (DCW), including training, supply and demand, models of care and compensation, will be addressed. Next, Carder et al. will compare workforce recommendations from the 2003 Assisted Living Workgroup (ALW) report to current regulations. Many states have incorporated recommendations including criminal background checks and training while few have required staff performance evaluations and policies to improve retention. Morgan et al. examine AL residents’ care convoys’ impact on resident outcomes utilizing data from interviews with AL staff, external health care professionals, residents and family members (n=219). Policies, practices, work overload, time constraints, lack of training and turnover impacted DCW involvement in care convoys. Bender et al. analyze data from 14 DCWs and 16 executive directors from 4 ALs to examine how staff implement and understands end-of-life care policies and procedures. Limited training and communication around death present opportunities for improvement to support DCWs experiencing grief and bereavement. The discussant will address the importance of workforce as part of the network providing quality of care and improving quality of life of individuals receiving LTC.

Abstract P326: Health Status and Frailty in Assisted Living and Nursing Home Residents

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Amrit Kanwar ◽  
Ryan J Lennon ◽  
Kalyan Ghanta ◽  
Mandeep Singh ◽  
Veronique L Roger
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Assisted Living ◽  
Long Term Care ◽  
Physical Component Score ◽  
Term Care ◽  
Component Score ◽  
Sf 36

Objectives: To determine the prevalence and relationship of frailty and health status measures among residents of long-term care [nursing homes (NH) and assisted living (AL)] facilities. Resident and methods: Residents ≥ 65 years who are residents of NH and AL facilities at La Crosse county, Wisconsin, were assessed for frailty (gait speed, unintended weight loss, and grip strength), comorbidity (Charlson index), and quality of life (QOL) [Short Form (SF)-36]. Results: Among 96 participants (57 from NH and 39 from AL), 78% were frail. The prevalence of frailty (77% vs. 79%), comorbidity (2.0 vs. 2.0), and poor health status did not differ between residents of NH and AL living facilities. Frail residents were older and had higher comorbidity index (2.0 vs. 0, p=0.02), including diabetes mellitus, hypertension, and heart failure. Frailty had the strongest correlation with the SF-36 Physical Component Score (r=-0.45), Figure. It exhibited weaker associations with comorbidity and the SF-36 Mental Component Score. Overall, SF-36 for physical component was lower among frail residents (33 vs. 48, p<0.001). Following adjustments by linear regression, compared to those without frailty, frail residents had lower adjusted quality of life scores. Conclusion: Frailty was highly prevalent among residents of long-term care facilities and did not differ between NH and AL facilities. We noted significant correlations between frailty, comorbid conditions, and poor quality of life.

scholarly journals Assisted Living Administrators’ Mental and Emotional Health During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1033-1033
Author(s):  
Jaclyn Winfree ◽  
Ozcan Tunalilar ◽  
Jason Kyler-Yano ◽  
Serena Hasworth ◽  
Paula Carder
Keyword(s):  
Assisted Living ◽  
Emotional Health ◽  
Qualitative Interviews ◽  
First Year ◽  
Term Care ◽  
Health Crisis ◽  
Staff Morale ◽  
Global Pandemic

Abstract Little is known about assisted living (AL) administrators’ mental and emotional health, particularly during a global pandemic in which most of their residents are highly vulnerable to infection, hospitalization, and death. Considering that administrator turnover and burnout have been associated with negative outcomes such as decreased quality of resident care, low staff morale, and reduced financial solvency, this study examined how AL administrators described their mental and emotional state throughout the first year of the COVID-19 pandemic. Using thematic analysis, our team coded 18 qualitative interviews conducted from May-August 2021. The themes included declining physical health due to stress, feelings of inadequacy and self-doubt, and increased burnout. Many administrators described increased staffing challenges as directly impacting their daily stress levels. Some administrators described feeling guilty and doubting their interpretation or implementation of regulations, particularly in incidents that further distanced residents from peers and loved ones. A few administrators described their disposition or personality changing due to what they experienced during the pandemic. One administrator stated, “I'm not an anxiety person, but I feel anxiety about a lot of things. In fact, my doctor has talked to me about starting some medications to help with that.” Multiple administrators made comments such as, “I don't know that there could be a more stressful position than executive director of assisted living…the COVID pandemic reinforced that. This is rough.” Understanding AL administrators’ mental and emotional health during a public health crisis allows for understanding, supporting, and retaining critical leaders in long-term care communities.

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