Relationship Between Regulations/Industry and Needs of Consumers
It is obvious from the brief literature review of RCF users that current RCF residents would most closely resemble the nursing home population of previous decades. As the demand analysis in Chapter 2 underscored, more frail older persons than previously now reside in residential care alternatives, while nursing homes increasingly serve only the most severely impaired segment of the older population.
The demographic analysis in Chapter 6 verifies this earlier work. Compared to community residents, the residents of the RCF studied were older and more impaired and more likely to be female and widowed. In addition, some new information was provided regarding the prior residences of RCF consumers. Interestingly, fewer than expected came directly from their own homes or private apartments in the community. Almost half of the sample came from other assisted environments, such as retirement homes, foster care homes, or nursing homes. In addition, almost half had lived in the area for less than one year, implying that many residents might have moved to the vicinity to be closer to adult children.
The variables discriminating the RCF consumer from the community sample are primarily: (1) number of medications and inability to take them without assistance; (2) continence, with RCF residents having increasing difficulty with continence over time; (3) mental status, with almost one-fifth of the RCF residents having a diagnosis of dementia and showing significantly more impairment in mental status; and (4) increasing need over time for assistance with the instrumental activities of daily living.
While the sample for this study was small, and conclusions should be interpreted with caution, the findings still suggest some significant problems with current policies.