New issue brief examines nursing facility transition programs

The Alzheimer’s Association’s Public Policy Issue Brief on Nursing Facility Transition Programs Serving Older Adults with Cognitive Impairment by Jane Tilly, director of quality care, and Laura Boone, state policy specialist, explores the history, effectiveness and quality of these transition programs and makes subsequent policy and practice recommendations for those states developing or implementing programs to better serve the cognitively impaired and their families.

Governmental long-term care reforms in recent years have promoted consumer choice by offering people with disabilities more opportunities to choose their own services, service providers and when services are delivered. Medicaid, the largest governmental payer for long-term care, has many participants who have exercised their choice among home and community services. 

Many states have Medicaid nursing facility transition programs that offer residents the choice of leaving the facility to return home or to the community in a more home-like setting. Transition programs provide support during the transition period, in the hope that this added assistance will allow the resident to experience better quality of life and care upon returning to the community.  

As 70 percent of elderly nursing home residents had cognitive impairment in 2006 and 46 percent had a dementia diagnosis 2007, it is highly likely that transition programs frequently serve older persons with cognitive impairment. The Alzheimer's Association felt it was necessary to examine if the needs of individuals with cognitive impairment are identified and addressed in transition programs. 

Particular areas evaluated were: how effective are states in providing the necessary attention to assist individuals with cognitive impairment in making the decision to leave a facility; making arrangements for transition to the community; and managing services after transition.