A National Study of Assisted Living for the Frail Elderly: Final Summary Report. I. INTRODUCTION AND STUDY BACKGROUND


This summary combines information from final reports based on data collected in a series of surveys conducted in a national probability sample of assisted living facilities (ALFs). These data were collected as part of a study, "A National Study of Assisted Living for the Frail Elderly," funded by the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Planning and Evaluation (ASPE). Additional support for the study was provided by American Association of Retired Persons (AARP), the Administration on Aging (AoA), the National Institute on Aging (NIA), and the Alzheimer’s Association.

This paper summarizes the findings presented in four project reports:

  • Results from a telephone survey of a national sample of ALFs.
  • Results from in-person interviews with administrators, staff, and residents in a sample of high privacy or high service ALFs.
  • Results from follow-up interviews with residents (or their next of kin) who were discharged from the high privacy or high service ALFs within six months of the baseline interview.
  • Analysis of the effect of facility characteristics on such key issues as the match with the assisted living philosophy and affordability.

This overall summary has five sections, four of which have appeared as portions of separate project reports.

  • The first section presents the overall study goals and design.

  • Section II presents data on a nationally representative sample of ALFs and provides a basic description of the industry.

  • Section III summarizes information on a subset of these facilities. This subset is comprised of the group of ALFs that seemed most likely to embody the philosophical tenets of assisted living. Thus, the ALFs studied in this part of the project were restricted to those that offered either a relatively high level of services or a relatively high privacy environment. In these high privacy or high service ALFs, all the administrators and a random sample of staff and residents were interviewed in-person. In Section III summarizes information on a subset of these facilities. This subset is comprised of the group of AL

  • Section IV of this report describes residents who were interviewed in the high privacy or high service facilities but left those ALFs within an average of six months of that original interview. It focuses on the reasons for their exit or discharge and the characteristics of ALFs associated with “earlier” discharges.

  • Section V presents an examination of the facility characteristics associated with differences on key issues, such as the ability of residents to age in place, affordability for lower income elderly, willingness to meet residents’ personal care needs, and, more generally, the degree to which the facility exhibits elements reflecting the philosophy of assisted living.

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