Residents in long-term care: a case-controlled study of individuals in nursing homes and assisted living in Washington State

Abstract

The major purpose of this study was to determine some of the differences in selected variables of cost and quality of life between 86 individuals 65 years old or older, matched on a scale of functional ability, living in nursing homes and in assisted living facilities. Nursing homes are the least preferred and most costly form of long-term care. Although case study and anecdotal evidence suggests that for some nursing-home-eligible individuals, assisted living may be a more desirable and more economical option, little empirical evidence is available. This study randomly selected 10 nursing homes and 10 assisted living facilities in a three-county area; 10 residents from each selected facility who had lived there for three or more months were then randomly selected, and then individuals were matched in pairs with one from each type of facility, according to similar scores (within 2 points, 0 to 100 possible) on the SIP-NH. Individuals who fell within the potential matching range on the functional disability scale were also administered a quality of life instrument, the Ferrans & Powers QLI, as well as a global question regarding their perception of their quality of life. Data on all monthly costs were obtained.Matched pair T-tests performed on the data regarding cost and quality of life from the 43 pairs matched on the Sickness Impact Profile for Nursing Homes (SIP-NH) found the differences in scores on quality of life measures were not statistically significant, and that monthly costs of more than twice as much for nursing home residents compared to assisted living residents were statistically significant.