Interactions of Behavior and Environment as Contributing Factors in the Discharge of Residents with Dementia from Assisted Living Facilities

In this exploratory study, administrators of 14 assisted living facilities in Missouri were asked to describe resident behaviors and other issues that contributed to their decisions to discharge residents with dementia from their assisted living facilities to skilled nursing facilities. While resident behaviors themselves were factors influencing discharge, the interaction of those behaviors with the environment of the assisted living facility also influenced the decision. The interaction of behavior with environment, as much as any isolated behavior, suggested to the staff that it was necessary to consider discharge to a skilled nursing facility.