March 2, 2023
Assisted living (AL) is a growing, evolving, and changing sector of post-acute and long-term care (PALTC). It is a widely variable setting; and it’s often said that if you’ve seen one AL facility, you’ve seen one. AMDA’s Assisted Living Subcommittee is dedicated to educating practitioners and others about AL, supporting those who practice in this setting, staying ahead of trends and challenges, and advocating for AL residents.
“We have to be good teachers and communicate with as many people as we can about how to care for residents in assisted living,” says Sarah Howd, MD, CMD, the subcommittee’s chair. “Our subcommittee is comprised of people from different backgrounds—social work, advocacy groups, providers, and others. We have all kinds of stakeholders represented. This not only gives us a broad view of issues, it keeps us from focusing too much on one area. We are trying to promote the health and well-being of AL residents nationwide, and having an inclusive, varied collaborative is key.” She added, “We’re also trying to make it feasible for geriatric providers to get into AL and care for residents.”
One key challenge AL is facing involves the growing acuity of its residents. As a result, the traditionally social/hospitality model of care has been evolving to include medical care and services. “We are promoting the idea of blended care. There is a huge benefit to the social aspect of life in AL, such as the ability to be social, physically active, and mentally engaged. Yet most residents have some medical needs, and many who enter assisted living have already been using home care services and supports,” said Dr. Howd.
The subcommittee worked with the Centers for Disease Control and Prevention and the Center for Excellence in Assisted Living (one of the advocacy groups represented on the subcommittee) to develop infection control education for nurses working in assisted living. “We put together some cutting-edge materials, and we presented an AMDA webinar on this topic,” Dr. Howd noted.
Memory care is a key focus for the subcommittee, according to Dr. Howd: “About 70% of AL residents have some level of cognitive impairment and 40% have a diagnosis of dementia. If these individuals are to be able to age in place, they will need blended care.”
There will be a session at PALTC23 this month on Memory Care Matters! Advocacy Updates in Assisted Living Focusing on Dementia. As Dr. Howd explained, “We are trying to educate people about how to care for assisted living residents and keep them safe and supported in the least restrictive setting possible.” The subcommittee also is sponsoring another session, An Interdisciplinary, Primarily non-Pharmaceutical Approach to Managing Behaviors in Memory Care.
While assisted living communities aren’t required by federal law to have a medical director, there is a significant role for the physician leader in this setting. “Putting out a sample AL medical director contract has been an ongoing project for our subcommittee. As a medical director in AL, you can offer guidance more freely, conduct reviews, implement checklists and other tools, and brainstorm about things like behavioral management and falls prevention,” she said, and added that research shows that during the pandemic, AL communities with medical directors had greater success with infection control.
Like so many of her colleagues, Dr. Howd is looking forward to traveling to Tampa for PALTC23. “We do so much virtual communication. I am excited to be face-to-face with so many like-minded people. It’s so valuable to build and maintain these relationships, and there are many opportunities for this at AMDA,” Dr. Howd observes. She also notes that coming from cold and snowy Rochester, NY, she is looking forward to spending time in warm and sunny Tampa.
