An analysis of the 2010 National Survey of Residential Care Facilities data, completed by George Mason University (GMU) researchers, helped establish some important distinctions among the populations and care needs of residents in small and large assisted living communities nationwide. 

“It’s important to recognize we are not drawing conclusions on the quality of care between communities of different sizes,” says Andrew Carle, executive-in-residence/director of the program in Senior Housing Administration at GMU. “The care required by an older adult with chronic conditions and those who are younger, dealing with severe mental illness or a developmental disability, or those afflicted with Alzheimer’s, is simply different. What we now know is these specialty populations are being more frequently served within the nation’s smaller communities.”

The researchers analyzed data gathered for the National Center for Health Statistics’ report. Data on almost 8,100 residents from 2,302 assisted living communities were analyzed.

The data were then compared for residents in communities categorized as small (four to 10 beds), medium (11 to 26 beds), and large/extra-large (more than 26 beds). The data in this report excluded communities exclusively for individuals with developmental disabilities or mental illness, but did not exclude assisted living communities that co-housed seniors and individuals with severe mental illness or developmental disabilities.

Following are some highlights of the study:

■ Small Community Characteristics: Small assisted living communities are nearly three times more likely to house “non-senior” residents under 65 years, with more than 21 percent of residents falling within this group, compared to slightly more than 7 percent in larger communities. Small communities housed more than twice as many residents with severe mental illness (13 percent versus 6 percent) and five times as many residents with a developmental disability (10 percent versus 2 percent). In addition, small communities were also more likely to house residents with Alzheimer’s or other forms of dementia (53 percent versus 41 percent), conditions typically associated with seniors 85 years and older.

The researchers noted that the data do not provide a clear picture of whether an individual with Alzheimer’s or dementia is in a setting designed for dementia care or co-housed with younger residents, or a combination both.

■ Larger Community Resident Characteristics: Larger assisted living communities typically had residents who were older than smaller communities. Nearly 85 percent of residents in large communities were older than 75 years, with 56 percent older than 85 years. Residents in larger communities had more chronic conditions than residents in small communities, such as congestive heart failure (36 percent versus 25 percent), hypertension (58 percent versus 50 percent), and osteoporosis (21 percent versus 14 percent).

GMU researchers want to pursue a second phase of the study that would compare specific quality-of-life indicators of an average assisted living resident to a peer-acuity senior who chooses to stay at home.

Carle added that such a study would be the first to compare at-home seniors to those in assisted living. It would also help “in separating what is thought of as a ‘typical’ assisted living resident from the specialized groups, versus viewing all assisted living communities as the same.”