A new study gives more insights into how much time older people in assisted living spend in and out of it.
Long-term care communities look at “home time” — being alive but not in a healthcare institution — as a quality metric. A team examined the variation in home time among people in assisted living communities in the first year after they were admitted. That is, they were in home time at the assisted living community but were not in home time if they had to go into a nursing home, were hospitalized or went into hospice. The researchers also evaluated the link between state regulations for direct care worker training and staffing for licensed workers.
Overall, the team found that people in assisted living communities who were eligible for Medicare and Medicaid had substantially shorter home time compared to Medicare-only residents. The team said the difference is largely due to longer time spent in nursing homes.
Data used came from 59,831 fee-for-service (FFS) Medicare beneficiaries who went into 12,143 assisted living communities in the United States. The average age of participants was 81.2 years old, and nearly half of the residents were older than 85. During the first year after going to a nursing home, 12.2% of the people passed away.
The residents spent, on average, 94% of their time at home or in assisted living, 0.4% of the time in the emergency room, 1.8% in hospital, 3.6% in a nursing home, and 0.2% of their time in hospice. Notably, the researchers found that people with chronic conditions, including Alzheimer’s disease and dementia, spent less time at their home in the one-year span.
The team also found that assisted living regulations for direct care workers affected residents’ home time.
“We found a negative association between home time and greater state assisted living regulatory specificity for licensed staffing, with virtually all ‘lost’ days being spent in nursing homes,” the authors wrote. “Several possible explanations may be considered. Although higher licensed staffing requirements may increase the presence of licensed staff in assisted living communities, it may also cause reallocation of resources from areas that are either not regulated or already exceeded the regulatory requirements.”
Another reason for that is because greater licensed staffing requirements increase the ability of assisted living workers to identify which residents need more intensive care that can be better provided in nursing homes, the authors added.
