Comparison of Assisted Living for the Frail and Elderly

in Rural and Non-Rural Areas

Project Investigators:  Catherine Hawes, Ph.D. (Project PI); Charles Phillips, MPH, Ph.D., and Michael Sherman, Ph.D.

Project Overview: Completed August 2003

The main goal of this project is to compare the assisted living facilities available to the frail elderly dwelling in rural areas to those available to elderly dwelling in non-rural areas. Outside of nursing homes, the most common form of residential long term care is in "assisted living" (US -GAO, 1999; Mollica, 1998). During recent years, assisted living has also been the most rapidly growing form of senior housing. Assisted living is a congregate residential settling that provides 24 hours supervision and some personal care services. Depending on exactly how one defines such facilities, there are between 11,500 and 40,000 ALFs nationwide that provide services to between 600,000 and one million residents (ALFA, 1998; Hawes, Rose, and Phillips, 1999; Mollica, 1998). This compares to about 17,000 nursing homes with 1.6 million residents. Providers, many consumer advocates, and some researchers argue that assisted living is a promising new model for providing long term care, emphasizing independence, dignity and autonomy for consumers, and also one that may reduce nursing home use and long-term care costs (ALFA, 1998; Kane and Wilson, 1993; Leon, Cheung and Neumann, 1998). Despite this rapid increase in the supply of ALFs and growing interest in their performance, nothing is known about the role such facilities may playing meeting the needs of frail elders living in rural areas. Rural elders have high use of nursing homes and are more likely to live alone than older persons in non-rural settings. Thus understanding the role of ALFs may play in such settings is particularly critical.     

Project Funding Source:

Office of Rural Health Policy

Project Term:

September 2001-August 31, 2002

Project Reports:

Hawes, C., Phillips, C.D., Holan, S., and Sherman, M (2003).  Assisted Living in Rural America:  Results from a National Study.  Report to the Health Resources and Services Administration's Office of Rural Health Policy. FULL TEXT