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.
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.
2.
Blanchette K: New directions for state long-term care systems, volume III: Supportive housing. Washington, DC: Public Policy Institute, 1997.
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.
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.
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.
6.
Wilson KB: Assisted living: Reconceptualizing regulation to meet consumers' needs and preferences. Washington, DC: Public Policy Institute, 1996.
7.
Byrd WC, Byrd SB: Assisted living: Meeting the needs of an aging Georgia. J Med Assoc Ga. 1997; 86(2): 125-126.
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.
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.
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.
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.
12.
US General Accounting Office: Assisted living: Quality-of-care and consumer protection issues in four states(Rep. No. GAO/HEHS-99-27), 1999.
13.
Hedrick SC, Sales A, Sullivan J, et al.: Resident outcomes of Medicaid funded community residential care. Gerontologist. In press.
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.
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.
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.
17.
Morris JN, Hawes C, Fries BE, et al.: Designing the national resident assessment instrument for nursing homes. Gerontologist. 1990; 30(3): 293-307.
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.
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.
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.
21.
Mollica RL: State Assisted Living Policy. Portland, ME: National Academy for State Health Policy, 2000.
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.
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.
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.
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.
26.
Zimmerman SI, Sloane PD: Optimum residential care for people with dementia. Generations. 1999; Fall: 62-68.
27.
Davis KJ, Sloane PD, Mitchell CM, et al.: Specialized dementia programs in residential care settings. Gerontologist. 2000; 40(1): 32-42.
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.
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.
30.
Mor V, Sherwood S, Gutkin C: A national study of residential care for the aged. Gerontologist. 1986; 26(4): 405-417.
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.
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.
33.
Kane RA, Illston LH, Kane RL, et al.: Adult foster care in Oregon: Evaluation. Oregon Senior Services Division; Dept. of Human Resources, 1989.
34.
Greene A, Hawes C, Wood M, et al.: How do family members define quality in assisted living facilities?Generations. 1997; Winter: 34-36.
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.
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.
