Page Reviewed / Updated - February 25, 2010
When considering placing a loved one in an assisted living community, many families are concerned about the proximity of a hospital to the assisted living residence. The perspective of the family is that the closer the hospital is to the residence, the more likely the elderly individual is to receive immediate emergency care when required. In fact, so many families have this concern that a recent analysis of Google data found that this is one of the most common searches that adult children make when looking for assisted living for their aging parents. Our organization has studied this question in depth and has found, for a variety of reasons, the close proximity of an assisted living residence to a hospital does not actually make for better health outcomes. In fact, it may even be detrimental to the elderly individual when their health is looked at holistically.
In this article, we explore the reasons behind this conclusion and help families understand what better questions they might ask to assess how well an assisted living community can respond to an emergency.
It is important to remember that there are two components that make up the response time to an emergency: The time it takes to discover the emergency and the time it takes for emergency response, such as the arrival of an ambulance or the arrival at a hospital. Assisted living residents, might, for example, experience a fall in their shower. How quickly is their injury discovered? Does the residence have staff members who will notice their absence? Does the facility provide technology, such as fall sensors or have emergency call buttons placed around locations where accidents are likely to occur? These factors will play a major role in how soon the need for emergency care is discovered.
Once a need for emergency care has been recognized, there is the time it takes to reach medical care (or for medical care to reach the individual). How near a hospital is to the assisted living residence is only one factor in that equation. How responsive is the ambulance crew? How busy is the emergency room once the patient has arrived? Does the assisted living residence have medically trained personnel on staff who can respond and stabilize the individual? Given that so many other factors impact response time in an emergency, a hospital's proximity, and therefore the travel time to the hospital, plays only a small part.
Counter-intuitively, our research also found that proximity to a hospital could actually be a negative factor. Evidence shows that the closer an assisted living community is to a hospital, the higher the admission rate for any given member of that community. At first blush, this seems to be a rather straightforward, if not positive relationship. However, upon investigating the data behind these cases, a different and complex story emerges.
Assisted living community members located in close proximity to hospitals are admitted at higher rates for non-emergency and non-life threatening events than those living further away. These same patients exhibit a greater frequency of re-admission to emergency facilities than their peers. This leads to higher medical costs, with no correlation to increased standards of living or the overall health of patients. Furthermore, admission to a hospital is a major disruption to the life of the assisted living resident and generates higher levels of stress for their family members.
The data shows that an overwhelming majority of assisted living communities with high hospital admission rates simply do not have registered nurses on hand. Hospitalization and emergency services were simply over-utilized, as they were the exclusive health service available to assisted living members.
Given that a family's true concern is the well-being of their loved one in an emergency situation, what are the questions that should be asked to assess how well prepared an assisted living residence is? Our suggestion is for families to seek the following information:
Obtaining this level of information during an on-site tour at an assisted living community can be difficult. It is our recommendation that those seeking an assisted living facility utilize one of the free services that assist in determining if a residence will meet their requirements in advance of a site visit. Families can get help finding what services are offered at which assisted living communities here, free of charge.
The services described above may make an assisted living community more costly. However, any cost increase will very likely be offset by the fact that hospitals tend to be located in urban centers, and assisted living residences nearby in urban centers are almost always more expensive than those located in less densely populated area.