title: The relationship between psychiatric disorders and the ability to age in place in assisted living.
abstract: OBJECTIVE
  Residential care/assisted living (RC/AL) has become a popular long-term care option in the past decade, in part because these settings offer residents a more home-like environment than nursing homes (NHs) while still offering supervision and assistance to meet individuals' personal and healthcare needs. One of the goals of RC/AL is to facilitate residents' ability to age in place by providing access to needed services and thereby delaying NH admission. This article explores individual and facility-level characteristics associated with discharge from RC/AL to NH with particular attention to persons with a psychiatric disorder.
  
  
  METHODS
  A Cox proportional hazards model was used to examine the risk factors associated with discharge from RC/AL to NH for a nonrandom sample of 366 residents in 37 RC/AL facilities in one state.
  
  
  RESULTS
  Thirty-two percent of residents sampled had a psychiatric disorder. Residents with a psychiatric disorder were 1.78 times more likely to discharge to a NH. Other factors significantly associated with discharge from a RC/AL to NH included age (older), being married, more hospitalizations, for-profit ownership status, and part of a NH or continuing care retirement community.
  
  
  CONCLUSIONS
  This article identifies both facility and individual characteristics that increase the likelihood of RC/AL residents discharging to NHs. Given that one of the main findings is that persons with a psychiatric disorder are at increased risk of discharge to NH, there is a need for improved provision of services for this population in RC/ALs to reduce premature discharge to NHs and to support aging in place in RC/ALs.
authors.affiliation: School of Aging Studies, University of South Florida, Tampa, Florida 33620, USA. ddobbs@cas.usf.edu
authors.forename: Debra
authors.initials: D
authors.lastname: Dobbs
authors.forename: Jeanne
authors.initials: J
authors.lastname: Hayes
authors.forename: Rosemary
authors.initials: R
authors.lastname: Chapin
authors.forename: Pat
authors.initials: P
authors.lastname: Oslund
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D040561:Assisted Living Facilities / Q000706:statistics & numerical data*; D003710:Demography; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires