Better physical health and a college education are among the leading factors that could lower an assisted living resident’s risk of transferring to a nursing home later in life, according to new study results.
Using data from the National Health Aging Trends Study, University of Michigan, Ann Arbor researchers sought to identify baseline factors associated with transfers of assisted living residents to nursing homes. Their findings were published Monday in the Journal of the American Geriatrics Society.
The results could have implications for clinicians and stakeholders, with the baseline factors studied serving as a basis for assessing the risk of transfer to a nursing home in older assisted living residents, as well as developing interventions to delay and/or minimize that risk.
In addition, they indicated their findings could help inform quality improvement policies and guidelines in assisted living facilities, including providing opportunities for intervention to improve physical activities and activities of daily living performance.
Of the 970 assisted living residents analyzed, 143 (15%) transferred to a nursing home during the eight-year study period (2011-2019). They learned that assisted living residents who had less difficulty with activities of daily living, better physical performance, participation in physical activity and a college education were less likely to transfer to a nursing home as they aged.
With the demand for assisted living growing, the number of older adults at risk for needing assisted living services is anticipated to exceed 80.8 million by 2040, according to the Administration for Community Living’s 2020 Profile of Older Americans.
Reducing the chance of transfers
When older adults move into assisted living, they experience multiple challenges, according to the authors. Preventing further transfer to a nursing home is important due to the negative influence each transfer has on a resident’s physical and mental health, in addition to the lower cost of an assisted living setting.
Prior research showed that poorer physical performance is a predictor of a higher risk of falls, disability and mortality. Researchers also said that education established in early life influences individuals’ health behaviors and health over a lifetime. And better physical and activities of daily living performance has been consistently associated with a lower risk of transfer to a nursing home from an assisted living facility.
While the older adults in the study reported less difficulty with activities of daily living, they had substantial mobility-related problems. Researchers said it’s possible these residents learned to compensate for their disability and maintain their activities of daily living.
“In addition to common services provided by assisted living facilities — meals, housekeeping, assistance with activities of daily living — programs that prolong independent mobility and maintain physical function are needed for aging in place in assisted living,” researchers stated.
