Do assisted living facilities that offer a dementia care program differ from those that do not? A population-level cross-sectional study in Ontario, Canada.


Journal

BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548

Informations de publication

Date de publication:
16 08 2021
Historique:
received: 29 03 2021
accepted: 24 07 2021
entrez: 17 8 2021
pubmed: 18 8 2021
medline: 1 9 2021
Statut: epublish

Résumé

Many residents of assisted living facilities live with dementia, but little is known about the characteristics of assisted living facilities that provide specialized care for older adults who live with dementia. In this study, we identify the characteristics of assisted living facilities that offer a dementia care program, compared to those that do not offer such a program. We conducted a population-level cross-sectional study on all licensed assisted living facilities in Ontario, Canada in 2018 (n = 738). Facility-level characteristics (e.g., resident and suite capacities, etc.) and the provision of the other 12 provincially regulated care services (e.g., pharmacist and medical services, skin and wound care, etc.) attributed to assisted living facilities were examined. Multivariable Poisson regression with robust standard errors was used to model the characteristics of assisted living facilities associated with the provision of a dementia care program. There were 123 assisted living facilities that offered a dementia care program (16.7% versus 83.3% no dementia care). Nearly half of these facilities had a resident capacity exceeding 140 older adults (44.7% versus 21.6% no dementia care) and more than 115 suites (46.3% versus 20.8% no dementia care). All assisted living facilities that offered a dementia care program also offered nursing services, meals, assistance with bathing and hygiene, and administered medications. After adjustment for facility characteristics and other provincially regulated care services, the prevalence of a dementia care program was nearly three times greater in assisted living facilities that offered assistance with feeding (Prevalence Ratio [PR] 2.91, 95% Confidence Interval [CI] 1.98 to 4.29), and almost twice as great among assisted living facilities that offered medical services (PR 1.78, 95% CI 1.00 to 3.17), compared to those that did not. A dementia care program was more prevalent in assisted living facilities that housed many older adults, had many suites, and offered at least five of the other 12 regulated care services. Our findings deepen the understanding of specialized care for dementia in assisted living facilities.

Sections du résumé

BACKGROUND
Many residents of assisted living facilities live with dementia, but little is known about the characteristics of assisted living facilities that provide specialized care for older adults who live with dementia. In this study, we identify the characteristics of assisted living facilities that offer a dementia care program, compared to those that do not offer such a program.
METHODS
We conducted a population-level cross-sectional study on all licensed assisted living facilities in Ontario, Canada in 2018 (n = 738). Facility-level characteristics (e.g., resident and suite capacities, etc.) and the provision of the other 12 provincially regulated care services (e.g., pharmacist and medical services, skin and wound care, etc.) attributed to assisted living facilities were examined. Multivariable Poisson regression with robust standard errors was used to model the characteristics of assisted living facilities associated with the provision of a dementia care program.
RESULTS
There were 123 assisted living facilities that offered a dementia care program (16.7% versus 83.3% no dementia care). Nearly half of these facilities had a resident capacity exceeding 140 older adults (44.7% versus 21.6% no dementia care) and more than 115 suites (46.3% versus 20.8% no dementia care). All assisted living facilities that offered a dementia care program also offered nursing services, meals, assistance with bathing and hygiene, and administered medications. After adjustment for facility characteristics and other provincially regulated care services, the prevalence of a dementia care program was nearly three times greater in assisted living facilities that offered assistance with feeding (Prevalence Ratio [PR] 2.91, 95% Confidence Interval [CI] 1.98 to 4.29), and almost twice as great among assisted living facilities that offered medical services (PR 1.78, 95% CI 1.00 to 3.17), compared to those that did not.
CONCLUSIONS
A dementia care program was more prevalent in assisted living facilities that housed many older adults, had many suites, and offered at least five of the other 12 regulated care services. Our findings deepen the understanding of specialized care for dementia in assisted living facilities.

Identifiants

pubmed: 34399694
doi: 10.1186/s12877-021-02400-w
pii: 10.1186/s12877-021-02400-w
pmc: PMC8365888
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

463

Informations de copyright

© 2021. The Author(s).

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Auteurs

Derek R Manis (DR)

Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main St W, CRL-201, Hamilton, ON, L8S 4K1, Canada. manisd@mcmaster.ca.
Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, CRL-201, Hamilton, ON, L8S 4K1, Canada. manisd@mcmaster.ca.
ICES, Toronto, Ontario, Canada. manisd@mcmaster.ca.

Ahmad Rahim (A)

ICES, Toronto, Ontario, Canada.

Jeffrey W Poss (JW)

School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.

Iwona A Bielska (IA)

Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main St W, CRL-201, Hamilton, ON, L8S 4K1, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, CRL-201, Hamilton, ON, L8S 4K1, Canada.

Susan E Bronskill (SE)

ICES, Toronto, Ontario, Canada.
Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
Women's College Research Institute, Toronto, Ontario, Canada.
Sunnybrook Research Institute, Toronto, Ontario, Canada.

Jean-Éric Tarride (JÉ)

Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main St W, CRL-201, Hamilton, ON, L8S 4K1, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, CRL-201, Hamilton, ON, L8S 4K1, Canada.

Julia Abelson (J)

Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main St W, CRL-201, Hamilton, ON, L8S 4K1, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, CRL-201, Hamilton, ON, L8S 4K1, Canada.

Andrew P Costa (AP)

Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main St W, CRL-201, Hamilton, ON, L8S 4K1, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, CRL-201, Hamilton, ON, L8S 4K1, Canada.
ICES, Toronto, Ontario, Canada.
Centre for Integrated Care, St. Joseph's Health System, Hamilton, Ontario, Canada.
Schlegel Research Institute for Aging, Waterloo, Ontario, Canada.
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

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