Behavior Problems in Assisted Living Facilities

Abstract

Assisted living facilities (ALFs) are caring for increasing numbers of residents with cognitive impairment and physical disorders, yet little is known about behavior problems in these facilities. In the present study, surveys were mailed to all ALFs (N= 2,221) in Florida, asking administrators or key staff to identify categories, frequency, and severity of behavior problems observed in their residents. Respondents (n= 612) identified resistance to staff assistance, wandering, verbal aggression, and psychiatric/emotional problems as the most frequent problems, and physical aggression was rated as the most difficult. Facility capacity was inversely related to the proportion of residents with behavior problems—that is, smaller ALFs had a higher proportion of residents exhibiting behavior problems. Results suggest that behavior problems in ALFs are similar to those in nursing homes but not as frequent. This is likely because of restrictions in ALF admission criteria and policies prohibiting the use of restraints thereby resulting in fewer residents with cognitive impairment.