Assisted living care and nursing home care for people with dementia share similarities but also have differences, said a speaker at a Wednesday session at the Argentum Senior Living Executive Conference in Nashville, TN.

Many of the challenges for assisted living residents who have dementia are the same as they are for nursing home residents, Sandra Simmons, Ph.D., a geriatrics professor at Vanderbilt University’s School of Medicine and Center for Quality Aging, told attendees. Both populations are at risk for falls, functional decline and polypharmacy issues, among other challenges, she added.

“The time to provide [activities of daily living] care for those who require staff assistance is comparable to nursing homes,” Simmons said.

Although the time itself may be similar, however, the care provided for residents with dementia in assisted living varies in two big ways, one of her studies found. One, the assisted living residents did not actively resist care, although cooperation was variable, and none required two staff members for assistance. Simmons’ research found that the average time for ADL care for dementia residents in assisted living was 20 minutes per resident without bathing, and 35 minutes with bathing.

Currently, approximately 72% of assisted living communities offer dementia services. Communities, however, are licensed and regulated at the state level, and variability exists between states, Simmons said.

Forty states have the common “flexible staffing” approach, whereby assisted living facilities must staff a “sufficient” number to “meet resident’s needs,” she said. Nineteen states specify minimum standards for direct care staff, Simmons added.

Simmons encouraged assisted living providers to consider pilot-testing an academic web-based product designed to address staffing for dementia care. Those who are interested in learning more about the pilot tool can email her at

Elizabeth Newman is senior editor of McKnight’s Senior Living’s sister media brand, McKnight’s Long-Term Care News.