A Description of Board and Care Facilities, Operators, and Residents. 6.9 the “Niche” Served by Board and Care Homes

12/01/1995

It seems clear that board and care residents fall somewhere between nursing home residents and residents of other residential settings with fewer services. In general, board and care home residents are more impaired than residents of congregate apartments, for example (Griffith, personal communication, 1995); however, on average, they are less impaired than nursing home residents. Using data from a comparable time period for approximately 2,100 nursing home residents in 10 States, we found that board and care residents were somewhat younger and, on average, less impaired than nursing home residents in cognition, ADLs, and other areas of functioning (Phillips et al., 1994). For example, 65 percent of nursing home residents received assistance in locomotion, whereas only 9 percent of board and care residents received such assistance. Fifty-eight percent of nursing home residents received hands-on assistance or supervision in eating, while only 6 percent of the board and care residents received such assistance. Nearly two-thirds of nursing home residents had urinary incontinence, while only 23 percent of the board and care residents were incontinent. Slightly more than two-thirds of the nursing home residents had moderate to severe cognitive impairment, but only 40 percent of the board and care residents were similarly impaired. However, there does appear to be some overlap in the two populations. For example, 15 percent of the board and care residents received assistance in three or more ADLs, a level of impairment similar to that experienced by the vast majority of nursing home residents.

EXHIBIT 6-13. Prevalence of Psychotropic Prescriptions and Use Among Board and Care Facility Residents
Drug Class Prescribed Any Use
  %     SE     %     SE  
Antipsychotics 22 2.9 21 2.9
Antidepressants 17 0.9 16 0.7
Anxiolytics, Sedatives and Hypnotics 17 2.2 14 1.9
Barbiturates 2 0.4 2 0.4
Benzodiazepines 13 1.8 10 1.5
Miscellaneous 4 0.7 3 0.7
Antimanic agents 4 0.7 4 0.7

Thus, according to these data, board and care homes do have a definite long-term care “niche.” The residents they serve place them closer to nursing homes than residential settings such as congregate apartments, even those with enriched supportive services. On the other hand, few board and care home residents are as impaired as the average nursing home resident.

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