Housing with supportive services is an important long-term sector, but information about care provision to residents in these settings is largely unavailable. The role of individual characteristics versus facility identity in determining how care is provided is completely unexplored. Data from 60 facilities in a single state were used to investigate the degree to which individual characteristics and facility identity determined how much care was provided to residents. Individual characteristics had the greatest impact on the amount of direct care time received by individuals. Care that was dementia oriented (i.e., cueing), however, was more strongly affected by the identity of the facility than by individual characteristics. These results have important implications for how consumers should think about seeking, and policy makers should think about supporting, care for those with impaired cognitive status who utilize housing with supportive services.
Ballard, E. L.
,& Gwyther, L. P. (1990). Optimum care of the nursing home resident with Alzheimer’s disease: “Giving a little extra.”Durham, NC: Duke University Medical Center, Joseph & Kathleen Bryan Alzheimer’s Disease Research Center.
2.
Binstock, R. H.
, Cluff, L. E., & von Mering, O. (1996). Issues affecting the future of long-term care. In R. H. Binstock, L. E. Cluff, & O. von Mering (Eds.), The future of long-term care: Social and policy issues(pp. 3-18). Baltimore: Johns Hopkins University.
3.
Eckert, J. K.
, Namazi, K. H., and Kahana, E. (1987). Unlicensed board and care homes: An extrafamilial living arrangement for the elderly. Journal of Cross-Cultural Gerontology, 2, 377-393.
4.
Fries, B. E.
, Mehr, D. R., Schneider, D., Foley, W. J.,& Burke, R. (1993). Mental dysfunction and resource use in nursing homes. Medical Care, 31, 668-685.
5.
Fries, B. E.
, Schneider, D. P., Foley, J. W., Gavazzi, M., Burke, R.,& Cornelius, E. (1994). Refining a case-mix measure for nursing homes: Resource utilization groups (RUG-III). Medical Care, 32, 668-685.
6.
Gwyther, L. P.
(1985). Care of Alzheimer’s patients: A manual for nursing home staff. Washington, DC: American Health Care Association and Alzheimer’s Disease & Related Disorders Association.
7.
Harrington, C.
, DuNah, R., Bedney, B., & Carillo, H. (1994). Variations and trends in licensed nursing home capacity in the states, 1978-1993(Policy paper). San Francisco: University of California at San Francisco, Institute for Health and Aging.
8.
Hawes, C.
, Lux, L., Wildfire, J., Green, R., Packer, L. E., Iannacchione, V., et al. (1995). Study of North Carolina domiciliary care residents. Research Triangle Park, NC: Research Triangle Institute, Program on Aging and Long-Term Care, Health and Social Policy Division.
9.
Hawes, C.
, Morris, J. N., Phillips, C. D., Fries, B., Murphy, K., & Mor, V. (1997). Development of the Nursing Home Resident Assessment Instrument in the USA. Age and Ageing, 26(Supp. 2), 19-26.
10.
Hawes, C.
, Morris, J., Phillips, C. D., Mor, V., Fries B.,& Nonemaker, S. (1995). Reliability estimates for the Minimum Data Set for Nursing Facility Resident Assessment and Care Screening (MDS). The Gerontologist, 35(2), 172-178.
11.
Hawes, C.
, Wildfire, J., Mor, V., Wilcox, V., Spore, D., Iannacchione, V., et al. (1995). A description of board and care facilities, operators, and residents. Research Triangle Park, NC: Research Triangle Institute, Program on Aging and Long-Term Care, Health and Social Policy Division.
12.
Kane, R. A.
, & Wilson, K. B. (1993). Assisted living in the United States: A new paradigm for residential care for frail older persons?Washington, DC: American Association of Retired Persons.
13.
Leon, J.
, Chang-Kuo, C.,& Neumann, P. J. (1998). Alzheimer’s disease care: Costs and potential savings. Health Affairs, 17(6), 206-216.
14.
Morgan, L. A.
, Eckert, J. K., & Lyon, S. M. (1995). Small board-and-care homes: Residential care in transition. Baltimore: Johns Hopkins University.
15.
Morris, J. N.
, Fries, B. E., Mehr, D. R., Hawes, C., Phillips, C., Mor, V., et al. (1994). MDS Cognitive Performance Scale. Journal of Gerontology: Medical Sciences, 49(4), M174-M182.
16.
Phillips, C. D.
, & Hawes, C. (1992). Nursing home case-mix classification and residents suffering from cognitive impairment: RUG-II and cognition in theTexas case-mix data base. Medical Care, 30(2), 105-116.
17.
Phillips, C. D.
, Hawes, C., Greene, A., & Wood, M. (1995). Testing the reliability of the RAI for Assisted Living and Domiciliary Care (RAI-DM-1).Research Triangle Park, NC: Research Triangle Institute, Program on Aging and Long-Term Care, Health and Social Policy Division.
18.
Phillips, C. D.
, Spry, K., Hawes, C., Greene, A., Lux, L., & Wood, M. (1997). North Carolina adult care home time study. Beachwood, OH: Myers Research Institute, Menorah Park Center for the Aging.
19.
Redfoot, D.
, & Gaberlavage, R. (1991). Housing for older Americans: Sustaining the dream. Generations, 15, 35-38.
20.
Schneider, D. P.
, Fries, B. E., Foley, W. E., Desmond, M.,& Gormley, W. J. (1988). Case-mix for nursing home payment: Resource utilization groups (RUG-II). Health Care Financing Review, Annual Supplement, pp. 39-52.
21.
Wilson, K. B.
(1993). Assisted living: A model of supportive housing. In P. R. Katz, R. L. Kane, & M. D. Mezey (Eds.), Advances in long-term care(Vol. 2, pp. 196-219). New York: Springer.
