Do Assisted Living Facilities That Offer a Dementia Care Program Differ from Those That Do Not? A Population-Level Cross-Sectional Study in Ontario, Canada
Bibliographic record
Abstract
ABSTRACT Objective To identify the characteristics of licensed assisted living facilities that provide a dementia care program compared to assisted living facilities that do not provide such a program. Design, Setting, and Participants Population-level cross-sectional study in Ontario, Canada on all licensed assisted living facilities in 2018 ( n = 738). Methods Data on facility-level characteristics (e.g., resident and suite capacities, etc.) and the provision of other provincially regulated care services (e.g., pharmacist and medical services, skin and wound care, etc.) attributed to licensed assisted living facilities were examined. Multivariable Poisson regression with robust standard errors was used to model the characteristics of assisted living facilities associated with the provision of a dementia care program. Results There were 123 (16.7%) assisted living facilities that provided a dementia care program. Nearly half of these facilities had a resident capacity exceeding 140 older adults (44.7%) and more than 115 suites (46.3%). All assisted living facilities that provided a dementia care program also provided nursing services, meals, assistance with bathing and hygiene, and administered medications. After adjusting for facility characteristics and other provincially regulated care services, the prevalence of a dementia care program was nearly three times greater in assisted living facilities that offered assistance with feeding than those that did not (Prevalence Ratio [PR] = 2.91, 95% Confidence Interval [CI] 1.98 to 4.29), and almost twice as great among assisted living facilities that provided medical services than those that did not (PR = 1.78, 95% CI 1.00 to 3.17). Conclusions A dementia care program was more prevalent in assisted living facilities that housed many older adults, had many suites, and provided at least five of the other 12 regulated care services. These findings deepen the understanding of specialized care for dementia in assisted living facilities. BRIEF SUMMARY Question Do licensed assisted living facilities that provide a dementia care program differ from those that do not in Ontario, Canada? Findings Assisted living facilities that provide a dementia care program house many older adults, have many suites, and offer at least five of the other 12 regulated care services. Meaning Assisted living facilities that provide a dementia care program are larger and provide an array of care services. Disclosures We have no perceived or actual conflicts, financial or otherwise, to disclose. Author Contributions DRM and APC conceptualized the study. AR created the dataset, and DRM conducted the statistical analyses. DRM wrote the manuscript, and all authors critically read and contributed to it. Data Availability The dataset from this study is held securely in coded form at ICES. While data sharing agreements prohibit ICES from making the data set publicly available, access may be granted to those who meet pre-specified criteria for confidential access, available at www.ices.on.ca/DAS . The full data set creation plan and underlying analytic code are available from the corresponding author upon request, understanding that the programs may rely upon coding templates or macros that are unique to ICES.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".