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The Gerontologist 46:238-248 (2006)
© 2006 The Gerontological Society of America

An Empirical Typology of Residential Care/Assisted Living Based on a Four-State Study

Nan Sook Park, PhD1,, Sheryl Zimmerman, PhD2,3, Philip D. Sloane, MD2,4, Ann L. Gruber-Baldini, PhD5 and J. Kevin Eckert, PhD6

Correspondence: Address correspondence to Nan Sook Park, PhD, School of Social Work, The University of Alabama, Box 870314, Tuscaloosa, AL 35487-0314. E-mail: npark{at}

Purpose: Residential care/assisted living describes diverse facilities providing non–nursing home care to a heterogeneous group of primarily elderly residents. This article derives typologies of assisted living based on theoretically and practically grounded evidence.Design and Methods: We obtained data from the Collaborative Studies of Long-Term Care, which examined 193 assisted living facilities in four states: Florida, Maryland, New Jersey, and North Carolina. By using mixture modeling, we derived typologies in five different ways, based on: structure; process; resident case-mix; structure and process; and structure, process, and resident case-mix. Results: Although configurations of typologies varied as a function of criterion variables used, common themes emerged from different cluster solutions. A typology based on resident case-mix yielded a five-cluster solution, whereas a typology based on structure, process, and resident case-mix resulted in six distinct clusters. Medicaid case-mix/psychiatric illness and high resident impairment were two clusters identified by both strategies. Implications: Because of the wide variation in structure, residents, and services within assisted living facilities, typologies such as those described here may be useful in clinical practice, research, and policy. To the extent that public payment defines its own cluster, the potential for inequities in care merits careful attention.

Key Words: Typology • Residential care • Assisted living • Cluster analysis • Long-term care

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All GSA journals Journals of Gerontology Series A: Biological Sciences and Medical Sciences Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Copyright © 2006 by The Gerontological Society of America.