TABLE 14-5 Resident Reports of Unmet Care Needs in RCFs Known as Assisted Living

Unmet Need

Percent

Standard Error

Dressing

12

2.89

Locomotion

12

3.29

Toileting

26

12.07

Eating

0.0

0.0

Data for only those residents who received some help with that ADL.

SOURCE: Phillips et al. (2000).

errors, high rates of psychotropic drug use, poor management of behavioral symptoms among residents with Alzheimer’s disease or other dementias, including inappropriate use of physical restraints, and poorer functional outcomes for RCF residents compared to nursing home residents, which suggested neglect of care needs (Baldwin, 1992; Bates, 1997; Spore et al., 1995, 1996, 1997a, b; Stark et al., 1995; U.S. General Accounting Office, 1992a). In addition one study asked a national probability sample of assisted living residents who could respond about whether they had unmet care needs (Phillips et al., 2000).15 As shown in Table 14-5, among those residents who needed assistance with various ADLs, some residents did report needing more help than they received (e.g., had to wait so long for help with toileting that they wet or soiled themselves).

These findings are troubling, because state policymakers wish to expand the role of RCFs (Mollica, 1998). States have been permitting higher levels of acuity (e.g., admission or retention of residents who are bedfast, chairfast, or use wheelchairs), and many have begun allowing provision of daily or intermittent nursing care, skilled home care, and hospice care in RCFs (Hawes et al., 1993; Kane and Wilson, 1993; Manard, et al., 1992; Mollica, 1998).

LIMITATIONS OF ESTIMATES OF PREVALENCE OF ABUSE AND NEGLECT IN LONG-TERM CARE SETTINGS

The results of these studies suggest that abuse and neglect are widespread across residential long-term care settings. However, there is no

15  

This was a national probability sample of residents in ALFs that, relative to the general population of places calling themselves “assisted living,” provided either high services or high privacy.



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