Health Services/Policy
Characteristics of new residents of assisted living facilities: a case-control study Derek R. Manis* Derek Manis David Kirkwood Stacey Fisher Wenshan Li Peter Tanuseputro Zain Pasat Colleen Webber Andrew P. Costa
Background: The characteristics of older adults who transition to an assisted living facility versus who remain in the community are poorly understood. We examined the characteristics of new residents of assisted living relative to community-dwelling home care recipients.
Methods: We conducted a case-control study in Ontario, Canada. We obtained linked, individual-level health system administrative clinical, sociodemographic, and community-level data from new residents of assisted living from 04/01/18 to 12/31/19. New residents of assisted living were matched to home care recipients in a 1:4 ratio on age and sex. We obtained clinical, functional, sociodemographic, and community-level variables from InterRAI-HC assessments and other census-level datasets. We used conditional logistic regression to model associations with characteristics determinant of a transition to an assisted living facility.
Results: There were 3,088 new residents of assisted living (Mean [SD] age 86 [7.03] years, 67% female) who were matched to 12,352 home care recipients. New residents of assisted living had increased odds of two or more falls (aOR 1.37, 95% CI 1.20-1.57), a mood disorder (aOR 1.19, 95% CI 1.08-1.30), and cardiac arrhythmias (aOR 1.12, 95% CI 1.02-1.23). They were concentrated in communities with the highest income quintile (aOR 1.31, 95% CI 1.03-1.65) and less so in rural communities (aOR 0.60, 95% CI 0.51-0.71). They also had a decreased odds of having a spouse or partner caregiver versus a child (aOR 0.62, 95% CI 0.53-0.73) and a hospitalization in the last seven days versus no hospitalization in the last 90 days (aOR 0.72, 95% CI 0.59-0.87).
Conclusions: New residents of assisted living facilities have a history of falls, mood disorders, cardiac arrhythmias, and caregivers who are their children. Our findings also underscore the relationship between income and urban location for a transition to a privately financed assisted living facility.