Health and functional outcomes and health care utilization of persons with dementia in residential care and assisted living facilities: comparison with nursing homes.
OBJECTIVE
This study compares health and functional outcomes and health care utilization of persons with dementia residing in residential care/assisted living (RC/AL) facilities and nursing homes.


METHODS
The study uses data from a longitudinal cohort study of 1,252 residents with dementia in 106 RC/AL facilities and 40 nursing homes in four states.


RESULTS
Rates of mortality; new or worsening morbidity; and change in activities of daily living, cognition, behavioral problems, depressive symptoms, social function, and withdrawal did not differ between the two settings. However, because of death or transfer, only about one half of the persons with mild dementia and one third of those with moderate to severe dementia remained in RC/AL facilities 1 year after enrollment. In addition, hospitalization rates were greater among individuals with mild dementia in RC/AL facilities, largely because of a medically unstable subgroup with high nursing-home-transfer rates.


CONCLUSIONS
Many persons with dementia can be served equally well in either setting; however, those with major medical care needs may benefit from nursing home residence.
Sloane
Philip D
PD
Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC 27599, USA. psloane@med.unc.edu
Zimmerman
Sheryl
S
Gruber-Baldini
Ann L
AL
Hebel
J Richard
JR
Magaziner
Jay
J
Konrad
Thomas R
TR
D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003704:Dementia / Q000451:nursing*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009735:Nursing Homes; D017063:Outcome Assessment, Health Care; D012112:Residential Facilities