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Why People Leave Assisted Living

Mon, 06/04/2001 - 12:00am — Karen Stevenson
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Many people are interested in knowing whether assisted living facilities will reduce the utilization of nursing homes. Since assisted living is less expensive than nursing home care, many states are exploring ways to move people who qualify for Medicaid and who need nursing home care into assisted living facilities instead. In addition, people who would "rather die than move into a nursing home" are hoping to find that assisted living will reduce the chance that nursing home care is in their future.

A recent study done by researchers from Texas A&M University System Health Science Center and Myers Research Institute addressed some of these issues. These researchers studied what happened to people who were discharged from assisted living facilities, including those who died in them, to help identify ways to keep people in the facilities longer. They looked at the reason for the discharge, and and found that most (80%) occurred because the resident needed more care. Those who were transferred often had cognitive problems, and many had been in the facility only a short time, which may indicate that the original placement was inappropriate or that the facilities need to be able to provide more cognitive care services. Researchers noted that the single most important factor in preventing discharges was the presence of a full-time registered nurse (RN), since facilities with RNs on staff were able to provide a broader spectrum of care.

An interesting finding in the study was how the expectations of family members involved in placement decisions changed over time. When they first looked for a facility, most family members thought that the availability of a private bedroom and bath was the most important aspect of a facility. By the time a family member was discharged, many family members said that the most important criteria was the ability of a facility to adapt to changing care needs, possibly because that might have avoided the need for a transfer.

Many people are concerned about the cost of assisted living, which is overwhelmingly paid for out-of-pocket and is not covered by Medicare and generally not covered by Medicaid. However, only 8% of the transfers in the study were made because the resident ran out of money.

Researchers found that about 24% of assisted living facility residents were discharged each year, including about 8% who died in the facility or immediately after discharge. Of those who were discharged and did not die, about 1% were able to return home and another 7% ended up moving into the home of a relative. 28% moved into another assisted living facility and 64% moved into a place that provided more care, like a nursing home, hospital, or sub-acute unit.

Many people are interested in knowing whether assisted living facilities will reduce the utilization of nursing homes. Since assisted living is less expensive than nursing home care, many states are exploring ways to move people who qualify for Medicaid and who need nursing home care into assisted living facilities instead. In addition, people who would "rather die than move into a nursing home" are hoping to find that assisted living will reduce the chance that nursing home care is in their future.

A recent study done by researchers from Texas A&M University System Health Science Center and Myers Research Institute addressed some of these issues. These researchers studied what happened to people who were discharged from assisted living facilities, including those who died in them, to help identify ways to keep people in the facilities longer. They looked at the reason for the discharge, and and found that most (80%) occurred because the resident needed more care. Those who were transferred often had cognitive problems, and many had been in the facility only a short time, which may indicate that the original placement was inappropriate or that the facilities need to be able to provide more cognitive care services. Researchers noted that the single most important factor in preventing discharges was the presence of a full-time registered nurse (RN), since facilities with RNs on staff were able to provide a broader spectrum of care.

An interesting finding in the study was how the expectations of family members involved in placement decisions changed over time. When they first looked for a facility, most family members thought that the availability of a private bedroom and bath was the most important aspect of a facility. By the time a family member was discharged, many family members said that the most important criteria was the ability of a facility to adapt to changing care needs, possibly because that might have avoided the need for a transfer.

Many people are concerned about the cost of assisted living, which is overwhelmingly paid for out-of-pocket and is not covered by Medicare and generally not covered by Medicaid. However, only 8% of the transfers in the study were made because the resident ran out of money.

Researchers found that about 24% of assisted living facility residents were discharged each year, including about 8% who died in the facility or immediately after discharge. Of those who were discharged and did not die, about 1% were able to return home and another 7% ended up moving into the home of a relative. 28% moved into another assisted living facility and 64% moved into a place that provided more care, like a nursing home, hospital, or sub-acute unit.