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Assisted living operators reported serious challenges in implementing infection prevention and control practices for residents living with dementia during the COVID-19 pandemic, according to the results of a new study with data from seven states.

Investigators examined data provided by 119 administrators in 244 assisted living communities. Records from July 2020 to September 2021 showed difficulties maintaining recommended infection prevention and control practices. Among the findings:

  • Less than half of administrators found it feasible to close indoor common areas; 
  • All assisted living community types reported a challenge organizing safely distanced group activities; and 
  • More than half of residents with dementia did not wear a face covering or maintain physical distance from other residents when indicated.

Although all assisted living communities reported infection prevention and control problems, they were most pronounced in those communities that catered specifically to residents living with dementia, Sheryl Zimmerman, Ph.D., of University of North Carolina at Chapel Hill, reported. In those settings, residents often have more advanced dementia and fewer private accommodations, she noted.

The results highlight the need to support infection control capabilities when providing care for this “especially vulnerable population,” Zimmerman and colleagues wrote in the Journal of the American Geriatrics Society.

The researchers noted that 42% of assisted living residents have a dementia diagnosis, and as many as 38% of the remainder meet diagnostic criteria for probable dementia. Although the authors said that assisted living “is the primary provider of residential long-term care for persons living with dementia,” they said that the study’s findings also have implications for nursing homes. Almost half of nursing home residents have dementia, and although fewer than 1% of nursing homes are dementia-specific, 15% have dementia care units, they noted.

Data were collected during an ongoing study of dementia, medical and mental healthcare in assisted living.

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