Residents in assisted living are less healthy than the general older adult population, and often share many characteristics of older adults in nursing homes. However, their care needs can vary widely. Health characteristics of this population raise the question of which assisted living residents would benefit from preventive care services that can reduce mortality from a medical condition, but which can require five or more years to produce a benefit. For example, an older adult would need five to ten years to achieve a survival benefit from a colorectal or breast cancer screening. These longer timeframes may make such medical procedures less necessary or desirable for some, but not all, of the residents in an assisted living residence.
To determine what proportion of older adults might benefit from such preventive care services, researchers recently looked at the health characteristics of assisted living residents in the nationally representative Survey of Residential Care Facilities, and evaluated their mortality risk at the time of the study.
The researchers found that between 10 and 15 percent of assisted living residents were classified as being in good health and expected to live longer than 10 years. This group would most likely benefit from preventive care that has been shown to reduce morality after five or more years. However, for other study participants, researchers concluded there was “possible, but uncertain benefit from such services.” Thus, they recommend that “providers should individualize their discussions around the balance of risk and benefits in the context of the resident’s values.” The researchers suggest that their data, in combination with available data on preventive care services in assisted living, suggests that “inappropriate screening may be particularly high, but they also strongly emphasize the importance of individualized informed discussions with assisted living residents when faced with such potential preventive services.
Kistler CE, Zimmerman S, Ward KT, et al. Health of older adults in assisted living and implications for preventive care. The Gerontologist. (2016). gnw053 DOI:10.1093/geront/gnw053