Characteristics and outcomes of dementia residents in an assisted living facility

Background. Assisted living (AL) is the fastest growing segment of resident ial long-term care in the US. At least half of the estimated 1 million AL r esidents have dementia or cognitive impairment, with many AL facilities off ering specialized dementia services. Little research has been done on the d emographics, outcomes, or clinical variables of this population. Methods. Participants were a cohort of 144 residents admitted to the AL uni t of Copper Ridge, a specialized dementia-care facility. Comparison samples included 737 patients with dementia residing in other locations (home, nur sing home, and other assisted living facilities). Selected measures of cogn ition, behavior, medical health, and function were taken at admission to AL and at 6-month intervals. Results. When compared with residents of the dementia-specialized AL facili ty, dementia patients at home were younger, less cognitively impaired, and less likely to exhibit wandering, delusions, or aggression. Residents of a dementia-specialized nursing home had more cognitive impairment, greater me dical comorbidity, and were more dependent on caregivers. The 2-year mortal ity rate in the dementia-specialized AL was 23%, significantly lower than r ates reported for nursing homes. Primarily due to increasing care needs, mo st residents in the specialized AL relocated to a nursing home after a medi an stay of 10.9 months. Depression, falling, and wandering were significant predictors of this transition. Conclusion. Dementia-specialized AL facilities occupy a unique position in the long-term care continuum that is distinct from home-care and nursing ho me facilities. This research is the first step toward understanding the sig nificant dementia population residing in assisted living. Copyright (C) 200 0 John Wiley & Sons, Ltd.