A new study gives more insight into how much time older adults in assisted living spend in and out of the setting.
Long-term care providers look at “home time” — being alive but not in a healthcare institution — as a quality metric. A team of researchers examined the variation in home time among people in assisted living communities in the first year after they moved in. That is, they were in home time at the assisted living community but were not in home time if they had to move to a nursing home, were hospitalized or went into hospice. The investigators 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 the Medicare and Medicaid programs had substantially shorter home time compared with Medicare-only residents. The difference, according to the researchers, largely is due to longer time spent in nursing homes.
The data used came from 59,831 fee-for-service Medicare beneficiaries who moved into 12,143 assisted living communities in the United States. The average age of the older adults in the study was 81.2 years, and almost half of the residents were aged more than 85 years. For those who subsequently went to a nursing home, 12.2% of the people passed away within the first year.
The residents spent, on average, 94% of their time at home or in assisted living, 0.4% of the time in the emergency department, 1.8% in the 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 the finding is that requirements of greater licensed staffing 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.
This article originally appeared on McKnight's Long-Term Care News
