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The place of assisted living in long-term care and related service systems
- Authors:
- STONE Robyn I., REINHARD Susan C.
- Journal article citation:
- Gerontologist, 47(3), December 2007, pp.23-32.
- Publisher:
- Oxford University Press
The purpose of this article is to describe how assisted living (AL) fits with other long-term-care services. The authors analyzed the evolution of AL in the United States, including the populations served, the services offered, and federal and state policies that create various incentives or disincentives for using AL to replace other forms of care such as nursing home care or home care. Provider models that have emerged include independent senior housing with services, freestanding AL, nursing home expansion, and continuing care retirement communities. Some integrated health systems have also built AL into their array of services. Federal and state policy rules for financing and programs also shape AL, and states vary in how deliberately they try to create an array of options with specific roles for AL. Among state policies reviewed are reimbursement and rate-setting policies, admission and discharge criteria, and nurse practice policies that permit or prohibit various nursing tasks to be delegated in AL settings. Recent initiatives to increase flexible home care, such as nursing home transition programs, cash and counselling, and money-follows-the-person initiatives may influence the way AL emerges in a particular state. Implications: There is no single easy answer about the role of AL. To understand the current role and decide how to shape the future of AL, researchers need information systems that track the transitions individuals make during their long-term-care experiences along with information about the case-mix characteristics and service needs of the clientele.
Developing a research agenda for assisted living
- Authors:
- KANE Rosalie A., WILSON Keren Brown, SPECTOR William
- Journal article citation:
- Gerontologist, 47(3), December 2007, pp.141-154.
- Publisher:
- Oxford University Press
The authors describe an approach to identifying knowledge gaps, research questions, and methodological issues for assisted living (AL) research. They undertook an inventory of AL literature and research in progress and commissioned background papers critiquing knowledge on selected subtopics. A comprehensive list of researchable questions of potential utility to consumers, providers, and/or policy makers was identified, which AL researchers then rated as to their importance. The preliminary work facilitated a structured working conference of AL researchers. The top five priority topics identified as a result of the polling before the conference were consumer preferences, cost and financing, developing an information system for consumer decision making, developing quality measures, and resident outcomes. From conference discussion, conferees added other emphasis areas and refined the original ones. They flagged lack of standardized definitions and measures as barriers to building an empirically based AL literature. Conferees also identified distinctions between research on AL as a whole and research on interventions within AL. In an emerging area in which the literature cannot yet support rigorous comparisons, meta-analysis, or consensus conferences, the systematic approaches, including assembling researchers who use widely different methods, generated substantial agreement on a research agenda.
Assisted living and residential care in Oregon: two decades of state policy, supply, and Medicaid participation trends
- Author:
- HERNANDEZ Mauro
- Journal article citation:
- Gerontologist, 47(3), December 2007, pp.118-124.
- Publisher:
- Oxford University Press
The study describes Oregon state policy and supply developments for licensed long-term-care settings, particularly apartment-style assisted living facilities and more traditional residential care facilities. Data came from a variety of sources, including state agency administrative records, other secondary data sources, and key informant interviews. Descriptive statistics examined public financing, Medicaid reimbursement, and licensed bed supply trends from 1986 to 2004, as well as Medicaid resident use between 1990 and 2004. Residential care expansion, combined with nursing facility contraction, has transformed Oregon's supply of licensed long-term-care settings in favour of less institutional options. State financing, reimbursement, and licensing policies varied across provider type, with greater public resources supporting growth of assisted living facilities. By 2004, such settings were more likely to be Medicaid providers than residential care facilities and had a higher proportion of Medicaid residents relative to available bed supply. Implications: State financing and reimbursement policies may play a role in stimulating the supply of apartment-style assisted living available to low-income and/or rural service users. Less favourable policy conditions may have unintended consequences for the supply and use of other residential care settings.
Perceptions of the need for social work in assisted living facilities
- Author:
- VINTON Linda
- Journal article citation:
- Journal of Social Work in Long-Term Care, 3(1), 2004, pp.85-100.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
A growing number of assisted living facilities (ALFs) in the United States are caring for elders with disabilities. Residents often need a broad array of supports as their physical, mental, and social functioning declines. The need for social work competencies was examined in this study of 140 ALF administrators. The 31 competencies were borrowed from the CSWE/SAGE-SW National Competencies Survey Report. Only 17 of the respondents employed professional social workers but facilities with social workers were significantly more likely to offer bereavement, crisis, family, and substance abuse counseling. The majority of administrators agreed that social work competencies could be useful in their facilities; however, non-social workers appeared to be performing many of these tasks. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
The shape of care to come
- Author:
- VALIOS Natalie
- Journal article citation:
- Community Care, 22.2.01, 2001, pp.18-19.
- Publisher:
- Reed Business Information
The debate about long-term care for older people has raised the question of how it will be provided in future. Some analysts believe the next 20 years will see sheltered housing replacing residential care.
Housing frail elders: international policies, perspectives and prospects
- Editors:
- PYNOOS Jon, LIEBIG Phoebe S.
- Publisher:
- Johns Hopkins University Press
- Publication year:
- 1995
- Pagination:
- 297p.,tables,bibliog.
- Place of publication:
- Baltimore, MD
Part 1 looks at trends and policies in housing frail older people, and at the implications for long term care. Part 2 presents European approaches to the subject. Part 3 looks at the issue from an Israeli perspective and part 4 at the situation in the United States, Canada and Australia. Concludes with a comparative study of policies in 4 countries.
Residential care and housing: a model for the year 2050
- Author:
- HARBERT W.B
- Publisher:
- Help the Aged
- Publication year:
- 1993
- Pagination:
- 26p.,bibliog.
- Place of publication:
- London
Paper suggesting that long term care systems have been created by political, administrative, financial and staffing arrangements rather than the needs of individual users. Advocates a fundamental policy shift to dispersed or to sheltered housing and away from residential care in order to better meet the housing needs of older people.
Correlates of attitudes toward personal aging in older assisted living residents
- Authors:
- PARK Nan Sook, et al
- Journal article citation:
- Journal of Gerontological Social Work, 58(3), 2015, pp.232-252.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study explored factors contributing to older adults’ self-perceptions about their own ageing in assisted living (AL) communities. Data analysis was completed based on interviews with 150 older residents from 17 AL communities in the United States. The study examined the effect of objective factors (health-related variables/negative life events) and subjective factors (satisfaction with facility/social support) on residents’ attitudes toward personal ageing and assessed whether health perception mediated the relationship between health-related variables/negative life events and residents’ attitudes toward personal ageing. Multiple regression analyses found that functional disability and hearing impairment negatively affected attitudes toward personal ageing among AL residents, and satisfaction with social support positively influenced attitudes. Health perception mediated attitudes toward personal ageing. Findings suggest the importance of social workers helping older AL residents recognize social support as a means of promoting their positive self-regard. (Edited publisher abstract)
Reducing depression among older people receiving care: summary of intervention methods and findings
- Authors:
- LYNE K.J., et al
- Publisher:
- North Yorkshire and York Primary Care Trust
- Publication year:
- 2007
- Place of publication:
- York
Depression is very common among older people and often goes untreated. Common causes are loss of relationships through bereavement and loss of role. Another frequent cause of depression in older people is physical disabilities which prevent roles or activities which a person has especially valued. Difficulty in travelling outside one’s home is a common example. Others would be loss of valued activities like needlework, reading or writing through eyesight problems or arthritis. Depression is especially common within services for older people with many physical disabilities. Surveys have found around 25% of older home care customers to be depressed. Among another such group, older people who live in care homes, the proportion is around 40%. As life expectancy increases, more people suffer age-related physical disabilities. According to the 2006 White Paper, Our Health, Our Care, Our Say: “One of the greatest long-term challenges facing the health and social care system is to ensure that longer life means more years of health and well-being”. This concerns all services for older people – health services and social care, nursing and care homes, sheltered housing and home-based support services. How can they respond to depressed older people in their care? This intervention project explored whether depression could be reduced among older people, living in care homes and typically aged over 80, through guiding their regular care staff to assist life-improvements which particularly mattered to an individual.
A little something extra
- Author:
- BELCHER John
- Journal article citation:
- Community Care, 30.4.98, 1998, p.4.
- Publisher:
- Reed Business Information
Examines the concept of "extra care" for older people.