Aging in place in residential care/assisted living Elderly persons or their families often choose a residential care/assisted living (RC/AL) setting when activities of daily living (ADL) dependence precludes living at home. A major factor in the choice of RC/AL setting is the likelihood that the person will be able to stay there as long as desired, ideally until death (i.e., age in place). Several levels of variables influence prospects for aging in place versus having to transfer to a nursing home: community-level factors (state regulations, availablity of home health services); facility-level factors (size, staffing, physical environment, retention policy); and resident-level factors (health, ADL status, behavior, economic resources). The Collaborative Studies of Long-Term Care, an in-depth longitudinal study of 193 RC/AL facilities in Florida, North Carolina, Maryland, and New Jersey, collected one-year follow-up data from 2078 residents in three types of RC/AL facilities: homes with fewer than 16 beds, larger "new model" facilities that espouse a retention philosophy, and more traditional larger facilities. Operators were asked whether they would discharge residents for multiple reasons, and actual discharges were recorded. Results indicate that retention policies vary by state and by facility, as well as by specific resident needs. Also, policies are not always consistent with actual practices. In all four states, new-model facilities showed a higher percentage of transfers to nursing homes than the other two facility types, despite their being more likely to have retention policies for many resident needs.
Learning Objectives: Participants will recognize the comparative benefits and deficits of varying types of residential care, in particular with regard to the goal of aging in place. They will understand the importance of retention policies, and appreciate the factors that support or undermine these policies at the community and facility levels
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am employed as a Research Associate by the Sheps Center
for Health Services Research.