A Secondary Analysis of the Intensity of Hospice Visits Among Medicare Decedents in the Last Seven Days of Life by Place of Residence

2021 ◽  
pp. 104990912110648
Author(s):  
Pauline Karikari-Martin ◽  
Lirong Zhao ◽  
Lynn Miescier
Keyword(s):  
Nursing Home ◽  
Retrospective Analysis ◽  
Social Worker ◽  
Assisted Living ◽  
Secondary Analysis ◽  
Place Of Residence ◽  
Assisted Living Facility ◽  
Payment Policy ◽  
Medicare Data

Background In 2016, Medicare finalized the Service Intensity Add-on (SIA) payment policy to increase the intensity of hospice registered nurse (RN) or social worker (SW) visits in the last 7 days of life. The research objective was to compare the intensity of hospice RN or SW visits in the last 7 days of life among older decedents who received a hospice visit, while residing in a traditional home, an assisted living facility, or long-term nursing home. Methods A retrospective analysis using 2016-2018 Medicare data of decedents 65 years or older (n= 2 067 863) related to the Medicare SIA payment policy. Intensity was defined as the number and duration of hospice RN or SW visits in the last 7 days of life using Medicare claims code G0299 and G0155. Results Regression results suggest that decedents who received a SIA related visit while residing in an assisted living facility, had on average a slightly longer duration of hospice RN visits in the last 7 days of life, compared to decedents residing in a traditional home, after controlling for demographics and other factors (P<.0001). The duration of hospice RN visits remained unchanged among decedents who received a SIA visit in 2017 or 2018, when compared to 2016 (P <.0001). Overall the average number of hospice SW visits did not differ by place of residence among decedents who received a SIA visit. Conclusions Among decedents who received a SIA related visit, the duration of hospice RN visits were slightly different by place of residence.

Hospice Attitudes among Assisted Living and Nursing Home Administrators, and the Long-Term Care Hospice Attitudes Scale

2006 ◽  
Vol 9 (6) ◽  
pp. 1388-1400 ◽  
Author(s):  
Debra Jean Dobbs ◽  
Laura Hanson ◽  
Sheryl Zimmerman ◽  
Christianna S. Williams ◽  
Jean Munn
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Long Term Care ◽  
Term Care ◽  
Nursing Home Administrators

Factors Associated With How Long People Would Like to Live

2019 ◽  
Vol 40 (4) ◽  
pp. 345-352
Author(s):  
Halimah Awang ◽  
Nik Ainoon Nik Osman ◽  
Norma Mansor ◽  
Nur Fakhrina Ab Rashid ◽  
Tan Lih Yoong
Keyword(s):  
Assisted Living ◽  
Older Persons ◽  
Long Term Care ◽  
Healthy Lifestyle ◽  
Assisted Living Facility ◽  
Term Care ◽  
Employment Opportunities ◽  
Factors Associated

This article examined the factors of how long people would like to live involving 462 respondents aged 40 years and older in Malaysia. Data collected through an online self-administered survey indicated that 75% of the respondents would like to live at least 80 years and on average most people would like to live 81 years. Rural respondents, those who agreed that they have a loving family, those who agreed that they want to continue working for as long as they can, respondents who believed that they will not need long-term care at 65 years and older, and those who may consider living in an assisted living facility were more likely to want to live at least 80 years compared with respondents who did not agree. Efforts should be targeted at promoting healthy lifestyle and providing more employment opportunities for older persons.

scholarly journals Variation in Hospice Services by Location of Care: Nursing Home Versus Assisted Living Facility Versus Home

2017 ◽  
Vol 65 (7) ◽  
pp. 1490-1496 ◽  
Author(s):  
Kathleen T. Unroe ◽  
Brittany Bernard ◽  
Timothy E. Stump ◽  
Wanzhu Tu ◽  
Christopher M. Callahan
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Assisted Living Facility ◽  
Care Nursing

scholarly journals Local Nursing Home Prescribing Patterns and Psychoactive Prescribing in Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 707-707
Author(s):  
Kali Thomas ◽  
Christopher Wretman ◽  
Philip Sloane ◽  
Anna Beeber ◽  
Paula Carder ◽  
...  
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Fixed Effects ◽  
Linear Models ◽  
Prescribing Patterns ◽  
Prescribing Practices ◽  
Term Care ◽  
Separate Model ◽  
Medication Prescribing

Abstract Because prescribing practices in long-term care settings may reflect regional influences, we examined how potentially inappropriate antipsychotic and antianxiety medication prescribing in assisted living (AL) compared to prescribing in nursing homes (NHs) based on their proximity, using generalized linear models adjusting for facility characteristics and state fixed effects. Data were derived from a seven state sample of AL communities and data for the same seven states drawn from publicly available data reported on the Nursing Home Compare website. In adjusted analyses, AL rates of antipsychotic use were not associated with the rates in the nearest or farthest NHs. However, AL communities that were affiliated with a NH had lower rates of potentially inappropriate antipsychotic use (b=−0.27[95%CI=−0.50,−0.04]). In a separate model, antianxiety medication prescribing rates in AL were significantly associated with neighboring NHs’ rates of prescribing (b=2.65[95%CI=1.00,4.29]). Findings suggest efforts to change prescribing in NHs may influence prescribing in AL.

scholarly journals ASSOCIATION BETWEEN CONTINUOUS WEARABLE ACTIVITY MONITORING AND SELF-REPORTED FUNCTIONING IN ASSISTED LIVING FACILITY AND NURSING HOME RESIDENTS

2016 ◽  
pp. 1-8
Author(s):  
J. MERILAHTI ◽  
I. KORHONEN
Keyword(s):  
Nursing Home ◽  
Activities Of Daily Living ◽  
Assisted Living ◽  
Daily Living ◽  
Activity Patterns ◽  
Activity Level ◽  
Assisted Living Facility ◽  
Time Activity ◽  
Wrist Actigraphy ◽  
External Stimuli

Background: Physical functioning is a key factor in independent living, and its preclinical state assessment and monitoring during the subject’s normal life would be beneficial. Objectives: The aim of the study is to analyse associations between ambulatory measured physical activity behaviour and sleep patterns (wrist actigraphy) and self-reported difficulties in performing activities of daily living. Participants, setting and design:36 residents in assisted living facilities and nursing homes (average age=80.4±9.0 years) without dementia in free living conditions participated. Actigraphic monitoring is integrated with the facilities’ social alarm system. Measurements: Indices on activity level, activity rhythm, sleep pattern and external stimuli response of sleep-wake behaviours were extracted from the actigraph data and correlated (Spearman rank-order correlation) with activities of daily living measures. Bonferroni correction for multiple comparisons was applied. Results: Activity level (ρ=-0.49, p<0.05) and night-time activity variance (ρ=-0.69, p<0.01) had correlation with the activities of daily living scores. The similarity of subject-wise activity pattern to facility common activities had a trend with activities of daily living (ρ=-0.44, p<0.1). In longitudinal case analysis, sleep and activity patterns were found to be associated with local weather variables. Conclusions: Activity patterns as measured by actigraphy may provide objective information on older people’s behaviour related to functioning state and its changes in nursing home and assisted living facility settings. However, variance between individuals was large in this dataset which decreases the reliability of the results. Furthermore, external stimuli such as weather and facility-related activities can affect subjects’ activity and sleep behaviour and should be considered in the related studies as well.

scholarly journals Social Isolation in Long-Term Care Facilities Related to COVID-19: Effect on Resident Anxiety and Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 579-579
Author(s):  
Nazmus Sakib ◽  
Joseph June ◽  
Lindsay Peterson
Keyword(s):  
Risk Factor ◽  
Nursing Home ◽  
Family Support ◽  
Social Isolation ◽  
Assisted Living ◽  
Long Term Care ◽  
Virus Spread ◽  
Term Care ◽  
Care Facilities

Abstract Loneliness is a common problem in long-term care. It has been associated with a higher risk of depression, aggressive behaviors, and anxiety and may be a risk factor for cognitive decline. Loneliness can exacerbate social isolation. The COVID-19 emergency brought on measures in Florida, beginning in March 2020, to separate nursing home (NH) and assisted living community (ALC) residents from each other and family members to limit virus spread. This study examines results of a survey with Florida NH (N=59) and ALC (N=117) administrators concerning effects of these measures. Scaled (1-5, lowest to highest) data indicate that resident anxiety was higher in NHs (M=3.40) than ALCs (M=3.17). Care disruptions related to limited resident-to-resident contact also were worse in NHs (M=3.74) than in ALCs (M=3.21), while care disruptions related to loss of family support were higher among ALCs (M=3.19) than in NHs (M=2.86). Implications of these findings will be discussed.

scholarly journals Diversity and Variation in Assisted Living Care, Nationally and Over Time

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 528-528
Author(s):  
Portia Cornell ◽  
Tetyana Shippee
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Long Term Care ◽  
Health Care Use ◽  
Medicare Beneficiaries ◽  
Term Care ◽  
Memory Care ◽  
State Subsidies ◽  
Over Time

Abstract Assisted living is generally understood to offer a greater degree of privacy and independence than a nursing home; most residents pay privately, with some receiving support from state subsidies and Medicaid; regulation and oversight are the purview of state agencies. Within these broad parameters, however, one assisted living community may look quite different from another across the country, or down the street, in its resident population and the regulations that govern its operating license. The purpose of this symposium is to explore that variation. The papers leverage an in-depth review of changes in assisted-living regulation from 2007 to 2019 and a methodology to identify Medicare beneficiaries in assisted living using ZIP codes. To set the stage, the first paper examines variation across assisted living licenses to identify six regulatory types and compare their populations’ characteristics and health-care use. The second paper analyzes trends over time in the clinical acuity of assisted living residents associated with changes in nursing home populations. The third paper investigates racial disparities in assisted living associated with memory-care designations and proportions of Medicaid recipients. The fourth investigates how regulation of hospice providers in assisted living affect end-of-life care and place of death. The final paper describes requirements related to care for the residents with mental illness in seven states. The symposium concludes with an expert in long-term care disparities and quality discussing the implications for policymakers, providers, and the population needing long-term care in assisted living.

scholarly journals QUALITY OF LIFE AND PERCEIVED NEEDS AMONG OLDER ADULTS RECEIVING LONG-TERM SERVICES AND SUPPORTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S625-S625
Author(s):  
Eleanor Rivera ◽  
Karen Hirschman ◽  
Mary Naylor
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Physical Therapy ◽  
Assisted Living ◽  
Secondary Analysis ◽  
Social Activities ◽  
Perceived Needs ◽  
Services And Supports

Abstract Long term services and supports (LTSS) are vital for older adults with physical and cognitive disabilities. LTSS can be provided in settings such as nursing homes, assisted living, or via community-based services. The aim of this study is to describe the perceived needs for older adults new to LTSS, examine whether those needs are met in the first three months of LTSS, and determine the relationship with quality of life (QoL). This secondary analysis included data from 470 older adults new to LTSS (average age: 81, 71% female, 51% white, 35% black, 20% Hispanic.) The main outcome of QoL was measured using a single item (“How would you rate your overall quality of life at the present time?”). Perceived needs included supportive equipment devices, transportation, physical therapy, and social activities. Analyses at baseline and three months included t-tests, ANOVAs and simple regression modeling. LTSS recipient reported needs at baseline were: 29% supportive equipment, 31% transportation, 20% physical therapy, and 25% social activities. Those who reported needs at baseline had a lower QoL than those who reported no needs (for all). At three months reported needs decreased by an average of 6% (range: 3%-10%). QoL ratings were associated with changes in physical therapy and social activities needs at three months. The implications of these results related to LTSS recipients’ QoL in the first three months of services, with emphasis on physical therapy and social activities needs, is an opportunity to be more person-centered in delivery of care.

scholarly journals Quality of Hospice Care at Home Versus in an Assisted Living Facility or Nursing Home

2018 ◽  
Vol 66 (4) ◽  
pp. 687-692 ◽  
Author(s):  
Kathleen T. Unroe ◽  
Timothy E. Stump ◽  
Shannon Effler ◽  
Wanzhu Tu ◽  
Christopher M. Callahan
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Hospice Care ◽  
Assisted Living Facility ◽  
Care At Home ◽  
At Home
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