A new study examining the differences between residents with moderately severe dementia who live in residential care settings, such as retirement communities and assisted living, and those who live in nursing homes or at home suggests actions those in senior living can take to benefit their residents, the lead author tells McKnight’s Senior Living.
Krista Lyn Harrison, Ph.D., an assistant professor at the University of California, San Francisco, and colleagues used data from the National Health and Aging Trends Study to compare the medical characteristics of 728 adults aged 65 or more across the three settings; 126 of them lived in residential care settings. Their findings were published today in the Journal of the American Geriatrics Society.
“In residential care settings, we observed high rates of people saying they lived alone, used mobility devices, had a hospital stay in the last 12 months or were bothered by pain,” Harrison said. Senior living communities could use that information, she added, “to ensure they provide social engagement opportunities; that their environment is designed to accommodate mobility impairments and facilitate independence despite use of mobility devices; minimize and prevent hospitalizations; and ensure that when they attend to residents’ wellbeing, they ensure residents are not in pain, whether that pain is addressed through medications, exercise or modified activities.”
Hiring staff members who are trained in geriatrics, palliative care and/or dementia, or offering staff members training in those areas, will help optimize care for residents with moderately severe dementia, Harrison said. “Geriatric palliative care approaches are well-suited to addressing the multi-domain needs of people with dementia and their families,” she said.
Researchers also found that residents of residential facilities with moderately severe dementia had less depression and anxiety, fewer chronic conditions and less unintentional weight loss than older adults with moderately severe dementia who lived at home or in nursing homes. Harrison said she hypothesizes that this finding reflects the type of person who lives in a residential care setting and the amount of medical support available.
“In other words, residential care is not a good setting for people with moderately severe dementia who also have multimorbidity and active symptoms of depression and anxiety,” she said. “People with dementia with more symptoms and functional or medical needs would likely need higher-touch help available at home, with one or more caregivers, or a nursing home.”
The researchers said they were not surprised to learn that senior living residents in the study, with an average age of 85, had higher incomes and were more likely to be U.S.-born and have post-high school education compared with those older adults living at home or in nursing facilities. Conversely, they found, residents of residential care settings were significantly less likely to be married or living together (16.4%) compared with those living at home (45.1%) or in nursing facilities (21.8%).
The most important message that those in senior living can take away from the study, Harrison said, is that “[o]ptimally supporting the quality of life of people with dementia requires attending to all three domains of wellbeing: social, functional and medical.”