TY - JOUR
T1 - Recommendations for Medical and Mental Health Care in Assisted Living Based on an Expert Delphi Consensus Panel
T2 - A Consensus Statement
AU - Zimmerman, Sheryl
AU - Sloane, Philip D.
AU - Wretman, Christopher J.
AU - Cao, Kevin
AU - Silbersack, Johanna
AU - Carder, Paula
AU - Thomas, Kali S.
AU - Allen, Josh
AU - Butrum, Kim
AU - Chicotel, Tony
AU - Giorgio, Pat
AU - Hernandez, Mauro
AU - Kales, Helen
AU - Katz, Paul
AU - Klinger, Juliet Holt
AU - Kunze, Margo
AU - Laxton, Christopher
AU - McNealley, Vicki
AU - Meeks, Suzanne
AU - O'Neil, Kevin
AU - Pace, Douglas
AU - Resnick, Barbara
AU - Schwartz, Lindsay
AU - Seitz, Dallas
AU - Smetanka, Lori
AU - Van Haitsma, Kimberly
N1 - Publisher Copyright:
© 2022 American Medical Association. All rights reserved.
PY - 2022/9/29
Y1 - 2022/9/29
N2 - Importance: Assisted living (AL) is the largest provider of residential long-term care in the US, and the morbidity of AL residents has been rising. However, AL is not a health care setting, and concern has been growing about residents' medical and mental health needs. No guidance exists to inform this care. Objective: To identify consensus recommendations for medical and mental health care in AL and determine whether they are pragmatic. Evidence Review: A Delphi consensus statement study was conducted in 2021; as a separate effort, the extent to which the recommendations are reflected in practice was examined in data obtained from 2016 to 2021 (prepandemic). In the separate effort, data were from a 7-state study (Arkansas, Louisiana, New Jersey, New York, Oklahoma, Pennsylvania, Texas). The 19 Delphi panelists constituted nationally recognized experts in medical, nursing, and mental health needs of and care for older adults; dementia care; and AL and long-term care management, advocacy, regulation, and education. One invitee was unavailable and nominated an alternate. The primary outcome was identification of recommended practices based on consensus ratings of importance. Panelists rated 183 items regarding importance to care quality and feasibility. Findings: Consensus identified 43 recommendations in the areas of staff and staff training, nursing and related services, resident assessment and care planning, policies and practices, and medical and mental health clinicians and care. To determine the pragmatism of the recommendations, their prevalence was examined in the 7-state study and found that most were in practice. The items reflected the tenets of AL, the role of AL in providing dementia care, the need for pragmatism due to the diversity of AL, and workforce needs. Conclusions and Relevance: In this consensus statement, 43 recommendations important to medical and mental health care in AL were delineated that are highly pragmatic as a guide for practice and policy..
AB - Importance: Assisted living (AL) is the largest provider of residential long-term care in the US, and the morbidity of AL residents has been rising. However, AL is not a health care setting, and concern has been growing about residents' medical and mental health needs. No guidance exists to inform this care. Objective: To identify consensus recommendations for medical and mental health care in AL and determine whether they are pragmatic. Evidence Review: A Delphi consensus statement study was conducted in 2021; as a separate effort, the extent to which the recommendations are reflected in practice was examined in data obtained from 2016 to 2021 (prepandemic). In the separate effort, data were from a 7-state study (Arkansas, Louisiana, New Jersey, New York, Oklahoma, Pennsylvania, Texas). The 19 Delphi panelists constituted nationally recognized experts in medical, nursing, and mental health needs of and care for older adults; dementia care; and AL and long-term care management, advocacy, regulation, and education. One invitee was unavailable and nominated an alternate. The primary outcome was identification of recommended practices based on consensus ratings of importance. Panelists rated 183 items regarding importance to care quality and feasibility. Findings: Consensus identified 43 recommendations in the areas of staff and staff training, nursing and related services, resident assessment and care planning, policies and practices, and medical and mental health clinicians and care. To determine the pragmatism of the recommendations, their prevalence was examined in the 7-state study and found that most were in practice. The items reflected the tenets of AL, the role of AL in providing dementia care, the need for pragmatism due to the diversity of AL, and workforce needs. Conclusions and Relevance: In this consensus statement, 43 recommendations important to medical and mental health care in AL were delineated that are highly pragmatic as a guide for practice and policy..
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U2 - 10.1001/jamanetworkopen.2022.33872
DO - 10.1001/jamanetworkopen.2022.33872
M3 - Review article
C2 - 36173637
AN - SCOPUS:85139377409
SN - 2574-3805
VL - 5
SP - E2233872
JO - JAMA network open
JF - JAMA network open
IS - 9
ER -