HHS report cites concerns over assisted living
Number of staff and turnover are key concerns
Residents of the nation’s assisted living facilities generally are satisfied with the treatment they receive but express concerns over the number of staff available and staff turnover, a new report from the U.S. Department of Health and Human Services (HHS) shows.
The report High Service or High Privacy Assisted Living Facilities, Their Resident and Staff is the result of a national study of assisted living facilities that has been under way since 1994.
"With the nation’s rapidly growing elderly population, it’s important that we have information on the long-term care options that are available for our grandparents, our parents, and ourselves. This study provides the first comprehensive look at the most rapidly growing form of senior housing — assisted living," says HHS Secretary Tommy Thompson.
Researchers surveyed residents and staff and visited a sampling of the nation’s assisted living facilities. Their report is a mixed bag of positive and negative findings.
On the positive side, the residents felt they were treated with respect and dignity. However, 12% of residents who needed help with locomotion and dressing, and 26% who needed help with using the toilet reported having unmet needs for assistance.
Staff were knowledgeable about issues concerning the care of common health problems among the frail elderly. However, the report concludes, in many facilities, a significant number of staff members were poorly informed about antipsychotic drugs and care for people with dementia.
The researchers found that the majority of staff in assisted living centers were completely unaware of what constitutes normal aging and what is a potentially reversible condition.
"Given the goal of enabling residents to age in place and the advanced age of the current residents, these results are particularly disquieting," the report says. Poor training and knowledge in these areas may in the future become more and more troublesome and risky, both for providers and residents since many of the conditions staff identified as a normal part of aging were potentially treatable and reversible."
The report looks at assisted living facilities that provide a high level of service and those that offer residents a high level of privacy. These two categories make up about 41% of all assisted living centers in the country. "High-service" assisted living facilities, which have licensed nurses on their staff and are able to meet the needs of more severely impaired residents, make up about 23% of all facilities, according to the report.
High-service facilities provide at least two meals a day, housekeeping, 24-hour staff oversight, personal assistance with medications, and activities of daily living. They have at least one full-time registered nurse on staff and provide nursing care.
"High-privacy" facilities have more than 80% private accommodations. However, the study points out, residents of assisted living facilities have more privacy and more choices than residents of nursing homes.
The study found that, on average, residents of assisted living facilities are less severely disabled than are nursing home residents. Nearly one-fourth of the residents in the survey had significant cognitive impairment and one in five required assistance with activities of daily living.
The facilities are well maintained, clean, and relatively home-like, and most are in suburban areas, according to the report.
Here are some other findings from the study:
- The median price was $1,800 a month with a wide variation in services covered by the base rate.
- More than half of the residents were 85 and older. Most were educated and relatively affluent.
- The vast majority of residents were female.
- Median staffing level was 14 residents for each caregiver.
- Staff reported being satisfied with most aspects of their work, except salary and advancement opportunities.
- Two in five staff members reported themselves to be in fair or poor health.
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