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COVID-19 Recommendations for Assisted Living: Implications for the Future

  • Vipperman, Andrew1
  • Zimmerman, Sheryl2, 3
  • Sloane, Philip D.2, 4
  • 1 School of Medicine, University of Virginia, Charlottesville, VA, USA
  • 2 Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC, USA
  • 3 Schools of Social Work and Public Health, University of North Carolina, Chapel Hill, NC, USA
  • 4 Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
Published Article
Journal of the American Medical Directors Association
AMDA - The Society for Post-Acute and Long-Term Care Medicine.
Publication Date
Feb 25, 2021
DOI: 10.1016/j.jamda.2021.02.021
PMID: 33773962
PMCID: PMC7904515
PubMed Central
  • Review Article


Objectives Assisted living (AL) emerged over 2 decades ago as a preferred residential care option for older adults who require supportive care; however, as resident acuity increased, concern has been expressed whether AL sufficiently addresses health care needs. COVID-19 amplified those concerns, and an examination of recommendations to manage COVID-19 may shed light on the future of AL. This review summarizes recommendations from 6 key organizations related to preparation for and response to COVID-19 in AL in relation to resident health and quality of life; compares recommendations for AL with those for nursing homes (NHs); and assesses implications for the future of AL. Design Nonsystematic review involving search of gray literature. Setting and Participants Recommendations from key governmental bodies and professional societies regarding COVID-19 in AL, long-term care facilities (LTCFs) in general, and NHs. Measures We collected, categorized, and summarized these recommendations as they pertained to quality of life and health care. Results Many recommendations for AL and NHs were similar, but differences provided insight into ways the pandemic was recognized and challenged AL communities in particular: recommending more flexible visitation and group activities for AL, providing screening by AL staff or an outside provider, and suggesting that AL staff access resources to facilitate advance care planning discussions. Recommendations were that AL integrate health care into offered services, including working with consulting clinicians who know both the residents and the LTC community. Conclusions and Implications Long-term care providers and policy makers have recognized the need to modify current long-term care options. Because COVID-19 recommendations suggest AL communities would benefit from the services and expertise of social workers, licensed nurses, and physicians, it may accelerate the integration and closer coordination of psychosocial and medical care into AL. Future research should investigate different models of integrated, interdisciplinary health care in AL.

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