Assisted Living During Emergencies

Angie Szumlinski Studies

The devastating effects of COVID-19 among older adults residing in long-term care settings have been well documented. Although much attention has been paid to COVID-19-associated mortality in nursing homes, less is understood about its effects on assisted living residents. Most assisted living residents are aged 80 years or older and many have multiple chronic illnesses, making them highly susceptible to poor outcomes of COVID-19. In a recent study published in JAMA Network Open, they examined the excess mortality among a U.S. cohort of assisted living residents during the COVID-19 pandemic.

In both years, almost one-half of the sampled residents (48%) were older than 85 years, 66% of participants were female, and 90% of participants were white. During the peak week in 2020 (April 8 to 14), assisted living resident mortality was 3.28 deaths per 1,000 residents per week compared to 2.24 deaths per 1,000 residents during the same week in 2019. After adjusting for facility fixed effects, assisted living residents experienced 17% higher overall mortality in 2020 compared with the year prior (24% higher mortality in the 10 states with the greatest community COVID-19 spread during the study window). These results suggest that assisted living residents experienced increased mortality during the COVID-19 pandemic consistent with increases observed among nursing home residents.

What this study reflects, is that future state and federal responses to pandemics targeted to long-term care are advised to explicitly identify the experiences of assisted living settings, recognizing that they differ from nursing homes in terms of the overriding model of care (social versus medical) and staffing (lower staffing levels and less nursing care). Research calls for specific attention to assisted living in response to pandemics and other emergencies. Stay well, stay informed, and stay tuned!