Older adult care needs have changed, but assisted living communities have not kept pace

A new report is calling for assisted living communities to change their medical and mental health services to match the evolving populations they serve.

The report, published in JAMA Network, offers 43 recommendations for updated standards of care to meet the new physical and mental health needs of older patients. 

Some of the researchers' recommendations include having policies to manage behaviors, including a gradual dose reduction program for psychotropic medications; care and service plan meetings should be conducted as needed and not strictly on a prescribed schedule; and the need for gathering data regarding direct care workers, including optimal staffing ratios based on resident acuity, and how best to use part-time and contract staff.

"The nature of the clientele in assisted living has changed dramatically," lead researcher Sheryl Zimmerman, PhD, co-director of the Program on Aging, Disability and Long-Term Care at the University of North Carolina at Chapel Hill, told The Washington Post on Dec. 3.

National Center for Health Statistics numbers show assisted living residents are older and sicker than before. Here are four key statistics:

  1. Fifty-five percent are 85 and older.

  2. Seventy-seven percent require help bathing, 69 percent with walking and 49 percent with toileting.

  3. More than one-third of residents have heart disease or arthritis.

  4. Thirty-one percent have diagnosed depression, 11 percent have serious mental illness and 42 percent have dementia or moderate to severe cognitive impairment.

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