Hedrick Susan, Guihan Marylou, Chapko Michael, Manheim Larry, Sullivan Jean, Thomas Mark, Barry Sarah, Zhou Andrew
Health Services Research and Development, VA Puget Sound Health Care System, 1100 Olive Way, Suite 1400, Seattle, WA 98101, USA.
Gerontologist. 2007 Jun;47(3):365-77. doi: 10.1093/geront/47.3.365.
The number of residents in assisted living has rapidly increased, although these facilities still primarily serve people who can pay out of pocket. The U.S. Department of Veterans Affairs was authorized to provide this level of care for the first time in the Assisted Living Pilot Program (ALPP). We describe the residents and providers, comparing them across three facility types and other populations, to assess the characteristics and feasibility of this new approach.
We assessed ALPP residents and providers across seven Veterans Affairs Medical Centers. We obtained information from medical records, assessment tools, and a provider survey.
We report here on 743 residents placed from 2002 to 2004. The Department of Veterans Affairs contracted with 58 adult family homes, 56 assisted living facilities, and 46 residential care facilities. The average ALPP resident was a 70-year-old unmarried White man referred from an inpatient hospital and living in a private residence prior to placement. Adult family homes enrolled residents requiring greater levels of assistance with activities of daily living than other facility types. Assisted living facilities were less likely than adult family homes to admit residents with functional disabilities and less likely than either adult family homes or adult residential care facilities to admit residents with certain care needs.
ALPP placed residents with a wide range of characteristics in community facilities that varied widely in size and services. This information can help determine the role of this type of care in and outside of the Department of Veterans Affairs.
尽管辅助生活设施仍主要服务于能够自掏腰包的人群，但入住此类设施的居民数量已迅速增加。美国退伍军人事务部首次在辅助生活试点项目（ALPP）中被授权提供这种护理级别。我们描述了这些居民和提供者，将他们与三种设施类型及其他人群进行比较，以评估这种新方法的特点和可行性。
我们评估了七个退伍军人事务医疗中心的ALPP居民和提供者。我们从医疗记录、评估工具和提供者调查中获取信息。
我们在此报告2002年至2004年安置的743名居民的情况。退伍军人事务部与58个成人家庭住宅、56个辅助生活设施和46个住宅护理设施签订了合同。ALPP的居民平均年龄为70岁，是未婚白人男性，从住院医院转诊而来，安置前居住在私人住宅中。成人家庭住宅招收的居民在日常生活活动方面需要比其他设施类型更高水平的帮助。辅助生活设施比成人家庭住宅接纳功能残疾居民的可能性更小，并且比成人家庭住宅或成人住宅护理设施接纳有特定护理需求居民的可能性更小。
ALPP将具有广泛特征的居民安置在规模和服务差异很大的社区设施中。这些信息有助于确定此类护理在退伍军人事务部内外的作用。
