Policies to protect persons with dementia in assisted living: déjà vu all over again?

Gerontologist. 2015 Apr;55(2):199-209. doi: 10.1093/geront/gnu179. Epub 2015 Mar 5.


Continued growth in the number of individuals with dementia residing in assisted living (AL) raises concerns about their safety and protection. In this Forum, we review current AL practices relevant to residents with dementia and present a rationale for examining the government role in protecting these individuals within this context. Since public oversight of AL is currently a state prerogative, we assess states' regulatory activity across 3 domains closely related to safety and protection of persons with dementia: environmental features, staffing, and use of chemical restraints. We then step back to consider the state policymaking environment and assess the feasibility of developing a minimum standard of regulations from one state to the next. This Forum concludes with a historical comparison between the contemporary AL market and the nursing home care market prior to the Nursing Home Reform Act of 1987, and we discuss how an increased amount of federal interest could improve existing state efforts to protect persons with dementia residing in AL.

Keywords: Federalism; Health policy; Nursing Home Reform Act; Residential care.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Assisted Living Facilities*
  • Deja Vu
  • Dementia / psychology
  • Dementia / therapy*
  • Health Care Reform
  • Health Policy*
  • Homes for the Aged / legislation & jurisprudence*
  • Homes for the Aged / standards
  • Humans
  • Nursing Homes / legislation & jurisprudence*
  • Quality of Health Care
  • Quality of Life