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The Gerontologist Advance Access published online on July 24, 2009
The Gerontologist, doi:10.1093/geront/gnp115
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Dementia and Transitioning From Assisted Living to Memory Care Units: Perspectives of Administrators in Three Facility Types

Susan G. Kelsey, PhD, MS1, Sarah B. Laditka, PhD2 and James N. Laditka, DA, PhD2

2 Department of Public Health Sciences, University of North Carolina at Charlotte

1 Address correspondence to Susan G. Kelsey, PhD, MS, Assistance + LLC, 5 Whistling Swan Road, Hilton Head Island, SC 29928. E-mail: skelsey{at}hargray.com


  Abstract

Purpose: This study examines transitioning residents with Alzheimer’s disease or a related disorder (ADRD) from assisted living facilities (ALFs) to memory care units (MCUs) from the perspective of 3 ALF organizational models: freestanding ALFs, ALFs with MCUs, and ALFs in continuing care retirement communities (CCRCs) with MCUs. Design and Methods: In-depth interviews were conducted with 37 ALF administrators, representing the 3 ALF types. Grounded theory identified major themes. Thematic analysis organized content. The constant comparison method compared themes among ALF types. Results: Administrators in freestanding ALFs were notably more likely to discuss transfer policies on admission. CCRCs with MCUs were more likely to make multidisciplinary decisions. In ALFs with MCUs, typically, the administrator and the director of nursing or resident care coordinator decided. In all ALFs, challenges included family resistance and denial of deficits, although there was notably less resistance in freestanding ALFs. CCRCs were much less likely than ALFs with MCUs to have trial admissions. Implications: ALF administrators may reduce family resistance to the MCU transfer by maintaining ongoing dialogue with family, discussing transfers at admission, conducting periodic resident reassessments, and providing opportunities for families to learn about ADRD.

Keywords: Alzheimer’s disease, Dementia, Dementia care units, Continuing care retirement communities, Residential care, Special care units

Received April 5, 2009; Accepted June 30, 2009

Decision Editor: Nancy Schoenberg, PhD


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