A recent poll of more than 1,000 older adults found they overwhelmingly want the government to support dementia care across the care continuum, including in assisted living settings.
The Age-Friendly Insights Poll on dementia care found the vast majority of adults favor policies that help older adults living with dementia, as well as their family caregivers: 92% support training to improve caregiving, 91% support payment for in-home assistance or respite care, and 84% support caregiver support groups.
The research was commissioned by the John A. Hartford Foundation.
Fifty-seven percent of the participating older adults said they are concerned about the potential effects of dementia. And if given a dementia diagnosis, they said, they want support and programs from healthcare and social service providers. Ninety percent of the older adults said that staying in their homes is important, with respondents reporting differences based on their race and income level.
JAHF President Terry Fulmer, PhD, RN, FAAN, said that the poll is relevant for residents of assisted living communities as well as older adults living anywhere else, because it focuses on age-friendly care. “Everything we do is targeted to every older adult, no matter where they are and no matter who is giving the care,” she said.
“The dementia care data we have tells us things we might expect — people are worried, and they want to make sure they have support in place,” Fulmer said, adding that they are also concerned about how to pay for that care. “People are really looking for a better answer to long-term care insurance. …It’s not affordable or universal. Universal long-term care insurance is what we all should be thinking about with the next administration.”
The evolution of assisted living
For assisted living operators, Fulmer said, it’s OK to market to prospective residents and their families if it’s in someone’s best interest to move into a community, but she said it’s not OK to “drum up business.” Providers must understand goals, preferences and values, she said.
To help residents achieve their goals and preferences in an assisted living community, Fulmer said, it’s critical that providers pay attention to “the four Ms”: what matters to residents, medication, mentation (the mind) and mobility.
On the flip side, she said, individuals and families must have conversations about a loved one’s expectations and whether the individual has a plan to remain in a home in the greater community as health deteriorates.
A big market exists for assisted living, Fulmer said, but fears persist about paying for it. She called for more industry transparency about variability in the care and services offered, pricing and Medicaid acceptance, for the benefit of members of the public and to help them make good choices.
“I believe they are well-intended as an industry, and we need to get transparency around truly what it is we’re talking about when we say ‘assisted living,’” she said. Creating various categories within the sector may help the public understand it better as well as understand the payment structure, Fulmer said.
The industry also needs to give people hope in the form of strategies, models, materials and professionals, she said.
The National Institute on Aging, Fulmer said, spends $3 billion annually on geriatric and aging science, including a proportional investment in Alzheimer’s disease and other forms of dementia. That investment, combined with new medications and the Centers for Medicare & Medicaid’s Guiding an Improved Dementia Experience, or GUIDE, model to support people living with dementia and their caregivers, gives people hope with science and industry working together, she said.
