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American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2003 Jul-Aug;18(4):240–246. doi: 10.1177/153331750301800413

Community residential care: Comparison of cognitively impaired and noncognitively impaired residents

Jane B Tornatore 1, Susan C Hedrick 2, Jean H Sullivan 3, Shelly L Gray 4, Anne Sales 5, Michael Curtis 6
PMCID: PMC10833777  PMID: 12955789

Abstract

Community residential care (CRC) is growing, with cognitive impairment the most common reason for CRC placement. We enrolled cognitively impaired and noncognitively impaired residents, informal caregivers, and providers in 219 CRC facilities for this study. Residents with cognitive impairment were older (p < .001), needed more activities of daily living (ADL) assistance (p < .001), and had a higher frequency of behavior problems (p < .001) than noncognitively impaired residents. Cognitively impaired and noncognitively impaired residents did not significantly differ in the facility-related factors they perceived as important or in the amount of control they felt they had over the decision to move. Including residents with cognitive impairment in future research and separately analyzing residents by cognitive status will give a more accurate picture of the needs of CRC residents.

Keywords: cognitive impairment, community residential care, Alzheimer's disease, dementia

Full Text

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Contributor Information

Jane B. Tornatore, Screen Inc., Seattle, Washington.

Susan C. Hedrick, Health Services Research & Development Center of Excellence, VA Puget Sound Health Care System; Department of Health Services, University of Washington, Seattle, Washington.

Jean H. Sullivan, Health Services Research & Development Center of Excellence, VA Puget Sound Health Care System, Seattle, Washington.

Shelly L. Gray, School of Pharmacy, University of Washington, Seattle, Washington.

Anne Sales, Health Services Research & Development Center of Excellence, VA Puget Sound Health Care System; Department of Health Services, University of Washington, Seattle, Washington.

Michael Curtis, Epidemiology and Evaluation Section, Maternal and Child Health Branch, California Department of Health Services, Sacramento, California.

References

  1. Zimmerman SI, Sloane PD, Eckert JK: Emerging issues in residential care/assisted living. In Zimmerman SI, Sloane PD, Eckert JK (eds.): Assisted Living: Needs, Practices, and Policies in Residential Care for the Elderly. Baltimore, MD: Johns Hopkins University Press, 2001, 317-331. [Google Scholar]
  2. Blanchette K: New directions for state long-term care systems, volume III: Supportive housing. Washington, DC: Public Policy Institute, 1997. [Google Scholar]
  3. Hawes C, Rose M, Phillips CD: A national study of assisted living for the frail elderly executive summary: Results of a national survey of facilities. Washington, DC: Public Policy Institute, 1999. [Google Scholar]
  4. Lewin-VHI, Inc., Research Triangle Institute: National study of assisted living for the elderly: Literature review update. Administration on Aging: US Department of Health & Human Services; (HHS-100-94-0024), 1996. [Google Scholar]
  5. Spector WD, Reschovsky JD, Cohen JW: Appropriate placement of nursing-home residents in lower levels of care. Milbank Q. 1996; 74(1): 139-160. [PubMed] [Google Scholar]
  6. Wilson KB: Assisted living: Reconceptualizing regulation to meet consumers' needs and preferences. Washington, DC: Public Policy Institute, 1996. [Google Scholar]
  7. Byrd WC, Byrd SB: Assisted living: Meeting the needs of an aging Georgia. J Med Assoc Ga. 1997; 86(2): 125-126. [PubMed] [Google Scholar]
  8. Goodman CC, Pynoos J, Stevenson LM: Board and care castaways: Older adults outside the long term care continuum. Soc Work Health Care. 1988; 13(4): 65-79. [DOI] [PubMed] [Google Scholar]
  9. Kane RA, Kane RL, Illston LH, et al.: Adult foster care for the elderly in Oregon: A mainstream alternative to nursing homes? Am J Public Health. 1991; 81(9): 1113-1120. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Mollica RL: State policy and regulations. In Zimmerman SI, Sloane PD, Eckert JK (eds.): Assisted Living: Needs, Practices, and Policies in Residential Care for the Elderly. Baltimore, MD: Johns Hopkins University Press, 2001, 9-33. [Google Scholar]
  11. Sloane PD, Zimmerman SI, Ory MG: Care for persons with dementia. In Zimmerman SI, Sloane PD, Eckert JK (eds.): Assisted Living: Needs, Practices, and Policies in Residential Care for the Elderly. Baltimore: The Johns Hopkins University Press, 2001, 242-270. [Google Scholar]
  12. US General Accounting Office: Assisted living: Quality-of-care and consumer protection issues in four states(Rep. No. GAO/HEHS-99-27), 1999. [Google Scholar]
  13. Hedrick SC, Sales A, Sullivan J, et al.: Resident outcomes of Medicaid funded community residential care. Gerontologist. In press. [DOI] [PubMed] [Google Scholar]
  14. Katzman R, Brown T, Fuld P, et al.: Validation of a Short Orientation-Memory-Concentration Test of cognitive impairment. Am J Psychiatry. 1983; 140(6): 734-739. [DOI] [PubMed] [Google Scholar]
  15. Davis PB, Morris JC, Grant E: Brief screening tests versus clinical staging in senile dementia of the Alzheimer type. J Am Geriatr Soc. 1990; 38(2): 129-135. [DOI] [PubMed] [Google Scholar]
  16. Davous P, Lamour Y, Debrand E, et al.: A comparative evaluation of the Short Orientation Memory Concentration Test of cognitive impairment. J Neurol Neurosurg Psychiatry. 1987; 50(10): 1312-1317. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Morris JN, Hawes C, Fries BE, et al.: Designing the national resident assessment instrument for nursing homes. Gerontologist. 1990; 30(3): 293-307. [DOI] [PubMed] [Google Scholar]
  18. Hawes C, Morris JN, Phillips CD, et al.: Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). Gerontologist. 1995; 35(2): 172-178. [DOI] [PubMed] [Google Scholar]
  19. Ware J, Kosinski M, Keller SD: A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Med Care. 1996; 34(3): 220-233. [DOI] [PubMed] [Google Scholar]
  20. Teri L, Truax P, Logsdon R, et al.: Assessment of behavioral problems in dementia: The Revised Memory and Behavior Problems Checklist. Psychol Aging. 1992; 7(4): 622-631. [DOI] [PubMed] [Google Scholar]
  21. Mollica RL: State Assisted Living Policy. Portland, ME: National Academy for State Health Policy, 2000. [Google Scholar]
  22. Ball M, Whittington F, Perkins M, et al.: Quality of life in assisted living facilities: Viewpoints of residents. J Appl Gerontol. 2000; 19: 304-325. [Google Scholar]
  23. Dittmar ND: Preserving independence, supporting needs, section 1: Facility and resident characteristics of board and care homes for the elderly. Washington, DC: Public Policy Institute, 1989. [Google Scholar]
  24. Quinn ME, Johnson MA, Andress EL, et al.: Health characteristics of elderly personal care home residents. J Adv Nurs. 1999; 30(2): 410-417. [DOI] [PubMed] [Google Scholar]
  25. Stocker KB, Silverstein NM: Assisted living residences in Massachusetts: How ready and willing are they to serve people with Alzheimer's disease or a related disorder? Am J Alzheimers Dis. 1996; 10: 28-38. [Google Scholar]
  26. Zimmerman SI, Sloane PD: Optimum residential care for people with dementia. Generations. 1999; Fall: 62-68. [Google Scholar]
  27. Davis KJ, Sloane PD, Mitchell CM, et al.: Specialized dementia programs in residential care settings. Gerontologist. 2000; 40(1): 32-42. [DOI] [PubMed] [Google Scholar]
  28. Kopetz S, Steele C, Brandt J, et al.: Characteristics and outcomes of dementia residents in an assisted living facility. Int J Geriatr Psychiatry. 2000; 15(7): 586-593. [DOI] [PubMed] [Google Scholar]
  29. Mitchell JM, Kemp BJ: Quality of life in assisted living homes: A multidimensional analysis. J Gerontol B Psychol Sci Soc Sci. 2000; 55(2): P117-P127. [DOI] [PubMed] [Google Scholar]
  30. Mor V, Sherwood S, Gutkin C: A national study of residential care for the aged. Gerontologist. 1986; 26(4): 405-417. [DOI] [PubMed] [Google Scholar]
  31. Reinardy J, Kane RA: Choosing an adult foster home or a nursing home: Residents' perceptions about decision making and control. Soc Work. 1999; 44(6): 571-585. [DOI] [PubMed] [Google Scholar]
  32. Gold D, Reis M, Markiewicz D, et al.: When home caregiving ends: A longitudinal study of outcomes for caregivers of relatives with dementia. J Am Geriatr Soc. 1995; 43(1): 10-16. [DOI] [PubMed] [Google Scholar]
  33. Kane RA, Illston LH, Kane RL, et al.: Adult foster care in Oregon: Evaluation. Oregon Senior Services Division; Dept. of Human Resources, 1989. [Google Scholar]
  34. Greene A, Hawes C, Wood M, et al.: How do family members define quality in assisted living facilities? Generations. 1997; Winter: 34-36. [Google Scholar]
  35. Kane RA, Baker MO, Salmon J, et al.: Consumer perspectives on private versus shared accommodations in assisted living settings. Washington, DC: Public Policy Institute, 1998. [Google Scholar]
  36. Kane RA, Wilson KB: Assisted living in the United States: A new paradigm for residential care for frail older persons? Washington, DC: Public Policy Institute, 1993. [Google Scholar]

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