Debra Dobbs, Ph.D., Hongdao Meng, M.P.H., Ph.D., Kathryn Hyer, M.P.P., Ph.D., and Ladi Volicer, M.D., Ph.D.
D. Dobbs, H. Meng, K. Hyer et al., "The Influence of Hospice Use on Nursing Home and Hospital Use in Assisted Living Among Dual-Eligible Enrollees," Journal of the American Medical Directors Association, Feb. 2012 13(2):189.e9–189.e13.
Assisted living facilities allow residents to "age in place" by adjusting their level of care and services to meet changing needs. For assisted living residents who are dying, hospice care can help facilitate their desire to stay out of hospitals or nursing homes. For their study, Commonwealth Fund–supported researchers examined over 12 months the outcomes of assisted living residents who are dually eligible for Medicare and Medicaid, seeking to determine the association of hospice use with nursing home and hospital admission.
Among the 658 assisted living residents followed over the study period, 6.8 percent were enrolled in hospice care and 10.2 percent died. Hospice enrollment was associated with a lower likelihood of both hospital and nursing home admissions.
Hospice enrollment may have allowed assisted living residents in need of palliative care to remain in their community. For this reason, assisted living providers should support and facilitate the use of hospice care among frail dual-eligible residents. Further research is needed to assess the impact of hospice care on residents' quality of life and on total health care expenditures among assisted living residents.