[Nursing homes versus assisted living facilities: Outcome quality regarding pressure ulcers, falls and malnutrition]

Z Gerontol Geriatr. 2015 Apr;48(3):263-9. doi: 10.1007/s00391-014-0655-4.
[Article in German]


Background: Assisted living has become more popular among individuals who are care-dependent or are threatened with care dependency as an attractive alternative to a standard nursing home. As differences regarding nursing care quality in both settings are so far unknown, the aim of the study was to compare the quality indicators occurrence of pressure ulcers, falls and malnutrition in both settings.

Material and methods: In spring 2010 a multicentre cross-sectional study on the prevalence of care problems was conducted including 3610 individuals in 31 nursing homes (NH) and 21 assisted living facilities (ALF) following a standardized study protocol. Comparative analyses of raw and adjusted prevalence of the care problems occurrence of pressure ulcers, falls and malnutrition were conducted.

Results: Individuals in the ALFs were on average older than those in the NHs (89.5 years vs. 83.2 years) but were more mobile and less care-dependent. The prevalence of care problems in the NHs compared to those in the ALFs showed the following results: pressure ulcers (NH = 3.9%, ALF = 2.3%), nosocomial pressure ulcer prevalence (NH = 2.3%, ALF = 0.2%), incidence of falls within 3 months (NH = 12.5%, ALF = 20.4%) and malnutrition according to a body mass index (BMI) ≤ 18.5 kg/m(2) (NH = 5.6%, ALF = 11.4%).

Conclusion: Due to the population differences, no final conclusions about the quality of care according to the analysed indicators can be made. While the prevalence of pressure ulcers was remarkably lower, falls and malnutrition had a higher prevalence in ALFs. Ongoing and systematic outcome quality surveys in different long-term care facilities are recommended.

Publication types

  • Multicenter Study

MeSH terms

  • Accidental Falls / prevention & control*
  • Accidental Falls / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Assisted Living Facilities / standards*
  • Assisted Living Facilities / statistics & numerical data
  • Female
  • Germany / epidemiology
  • Guideline Adherence / statistics & numerical data
  • Homes for the Aged / standards*
  • Homes for the Aged / statistics & numerical data
  • Humans
  • Incidence
  • Male
  • Malnutrition / epidemiology
  • Malnutrition / nursing*
  • Nursing Homes / standards*
  • Nursing Homes / statistics & numerical data
  • Pressure Ulcer / epidemiology
  • Pressure Ulcer / nursing
  • Treatment Outcome