Family Members' Views: What is Quality in Assisted Living Facilities Providing Care to People with Dementia?. 3.3 Which Aspects of Quality Matter Most: Results of Family Members' Views


As noted, we asked each of the focus group participants to review the list topics and issues the members had identified as key quality components and "vote" for the two or three elements they considered the most important by placing "sticker dots" next to the statement or topics. Members of five of the six groups did so. (One group refused, with members saying that what was most important varied over time and across family members. Moreover, they argued that all the topics they listed were an essential part of a high quality facility.) This section presents those results.

For the participants that voted, 11 "dots" were recorded. The results are presented in Exhibit 3. As shown, issues related to staffing received the most votes (25 percent). Related topics of communication with families (19 percent of the votes) and an individualized approach to resident's strengths, preferences and needs (12 percent) ranked , respectively, second and third. Thus, issues related to staffing and care practices garnered a total of 56 percent of the votes. Characteristics of the environment -- safety, security, and homelike environment garnered a total of 21 votes (19 percent of the votes). Family members also rated various aspects of care as important (activities, medical care, protective oversight, medication supervision, referrals, and hands-on physical care), receiving a total of 15 percent of the votes. When combined with individualized approaches to resident care, these aspects of care account for approximately 27 percent of the votes.

EXHIBIT 3. Results of Focus Group Participant Voting on Most Important Aspects of Quality
Domain Key Components of the Domain Number of Votes
Staffing Quality, previous and ongoing training, understand Alzheimer, cooperate with each other, staff turnover, continuity, physical contact, attitude, tolerance, caring, flexibility, qualifications, staffing ratio, policies 28
Communication with Family Helpful with orientation, have personal knowledge of resident, work with family, supportive of family 21
Care Responsive to Individual Resident Needs Learn what people need, appropriately design space for residents with Alzheimer's disease, continued evaluation of needs 13
Safety and Security Wanderguard, surveillance cameras, 24 hour supervision, locked unit, alarms, screening of staff 13
Homelike Environment No smell, appearance homey, meals and snacks--flexible and easy access 8
Activities Physical and mental, life, skills, home life activities, self-esteem (make-up, hair), social, pets, mixed activities, large or small groups, excursions, bus/van 7
Affordability No hidden costs, availability of Medicaid, acceptable increases in rates overtime 5
Availability of Medical Care 24-hours a day 4
Location of the Facility 3
Medication Management 2
Facility Makes Appropriate Referrals 2
Physician Regularly Visits the Facility 1
Personal Care 1
Quality of Management 1
Resident Cleanliness and Personal Appearance 1
Policies and Practices that Prevent Isolation of the Resident 1

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