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.

Derek R Manis,Andrew P Costa,Iwona A Bielska,Julia Abelson,Jean-Éric Tarride,Ahmad Rahim,Susan E Bronskill,Jeffrey W Poss

doi:10.1186/s12877-021-02400-w

Abstract

BackgroundMany 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.MethodsWe 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.ResultsThere 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.ConclusionsA 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.

Highlights

Dementia affects more than half of all residents who reside in assisted living facilities [1,2,3]
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

Summary

Introduction

Dementia affects more than half of all residents who reside in assisted living facilities [1,2,3]. Assisted living facilities provide congregate care in a residential setting to support independent living [11, 12], and assisted living facilities are referred to as retirement homes in Ontario, Canada. Assisted living facilities and retirement homes in the United States and Canada are regulated at the state- or provincial-level [12,13,14]. All licensed assisted living facilities in Ontario must provide, at a minimum, any two of the 13 provincially regulated care services to six or more older adults [16]. We identify the characteristics of assisted living facilities that offer a dementia care program, compared to those that do not offer such a program

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