Do impaired older persons with health care needs occupy U.S. assisted living facilities? An analysis of six national studies.
OBJECTIVE
The assisted living facility (ALF) is the fastest-growing noninstitutional long-term care alternative for frail older persons in the United States. This analysis assesses the extent to which older persons with physical and cognitive disabilities and health care needs occupy ALFs in the United States.


METHODS
Information on study design and six indicators of the occupancy patterns of older persons in ALFs were abstracted from six national studies. The collected data were based on reports by the administrators of ALFs.


RESULTS
The six reviewed studies had several methodologic weaknesses, resulting in different statistical populations of ALFs, samples with very different numerical and attribute properties, and findings based on disparate indicators. The older residents in ALFs were less physically and cognitively impaired than those in nursing homes. ALF facilities were more likely to admit or retain frail older persons when they had relatively minor or less serious physical or cognitive impairment or health care needs.


CONCLUSIONS
ALFs are currently serving older residents who require less nursing care and who are less functionally and cognitively impaired than those found in nursing homes. The more restrictive admitting and discharge criteria of a substantial share of ALFs guarantee their less frail occupant profile. This is, however, an extraordinarily diverse shelter and care alternative, and very frail older persons with serious chronic health problems can be found in ALFs. Average duration of stays may be as long as 3 years. Researchers must conduct more carefully executed studies with replicable methodologies that produce unbiased and generalized findings.
Golant
Stephen M
SM
Department of Geography, University of Florida, Gainesville, Florida 32611, USA. golant@geog.ufl.edu
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities / Q000706:statistics & numerical data*; D001509:Bed Occupancy / Q000706:statistics & numerical data*; D003627:Data Interpretation, Statistical; D004185:Disability Evaluation; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006306:Health Surveys; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D020380:Needs Assessment / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data