by Jordan Wingate
This article originally appeared in the School of Social Work 2023 Fall Impact Report.
With a 20-year record as the premier national organization for advancing the well-being of people who live and work in assisted living, the Center for Excellence in Assisted Living (CEAL) looks to build its expertise within its new home at the University of North Carolina at Chapel Hill. The organization, which became CEAL@UNC in February 2023, is now focused on its future, which includes drawing on the strength of UNC’s research and partnerships to develop evidence that further shapes assisted living practices, policies, advocacy, education, and the workforce for decades to come.
“This is the epitome of research with real-world impact,” UNC Chancellor Kevin Guskiewicz announced at the center’s dedication ceremony on Feb. 23 in Chapel Hill, N.C.
Distinct from nursing homes, assisted living communities are not required to provide nursing care but instead offer home-like living spaces for residents, at least two meals a day, around-the-clock supervision, and assistance with personal care. Since the 1980s, demand for assisted living has grown to the point that more than half of the nation’s nearly 1.6 million long-term care residents now reside in assisted living communities.
Assisted living seeks to ensure that residents maintain a good quality of life and receive necessary supportive care. But in practice, more residents are entering assisted living with greater medical and mental health needs, making it difficult for many assisted living communities to serve the population in ways that reflect the hallmark tenets of the field.
To meet these challenges, CEAL@UNC aims to work with others to guide change based on evidence. For example, two recent landmark studies published in the Journal of the American Medical Directors Association and in the Journal of the American Medical Association identified factors shaping assisted living care today, including residents’ health care needs and the lack of related services. This research established 43 recommendations for improving medical and mental health care in assisted living nationally and assessed the feasibility of each recommendation by studying how many settings were already following these recommendations in multiple states.
“By bridging research with practice and policy at a national level, we’re working to establish a new standard of care in assisted living,” said CEAL@UNC’s executive director, Sheryl Zimmerman, University Kenan Distinguished Professor at UNC’s School of Social Work and co-director of the Cecil G. Sheps Center’s Program on Aging, Disability, and Long-Term Care.
To build on the momentum of its previous efforts, CEAL@UNC is already pursuing three interrelated national initiatives.
The first focuses on assessing each state’s level of compliance with federal requirements for community-based long-term care. Sharing information about each state’s compliance will help guide research and quality improvement efforts across states.
The center has also established a brand-new national coalition — the Be Well in AL Coalition — to help assisted living settings put into practice the 43 recommendations for enhancing medical and mental health care for assisted living residents. Notably, Zimmerman and her colleagues have identified where these recommendations are already in place, enabling the new coalition to better direct support nationally.
The third goal is to increase the accessibility of assisted living research, much of which remains behind paywalls and in technical language that makes translation to real-world practice more difficult. CEAL@UNC intends to make all abstracts of this research available on its public website and to provide plain-language summaries of key takeaways for each publication.
Together, these initiatives will establish the state of the assisted living field, drive evidence-based changes, and achieve CEAL@UNC’s vision for ensuring that all people have access to person-centered assisted living options in which to live, age, visit, and work with dignity.
STAKEHOLDER INTERVIEW
Doug Pace, NHA, Chair of the Advisory Board, CEAL@UNC, Senior Director of Long-Term & Community-Based Care, Alzheimer’s Association
SSW: How would you describe CEAL@UNC’s role within the current landscape of research, service, and policy relating to assisted living?
DP: CEAL — now CEAL@UNC — is really the only national organization that brings other people and organizations together to look at how we improve the quality of care and quality of life of people who live and work in assisted living. It brings stakeholders with different perspectives together to examine assisted living through the lens of research, practice, and policy. It’s a unique opportunity to develop our collective voice together.
SSW: What are some key achievements of CEAL that you hope will develop further at CEAL@UNC?
DP: Among its many achievements, CEAL has focused on promoting person-centered care in assisted living; produced a report on the importance of fair and appropriate wages for people who work in assisted living; studied the impact of COVID-19 on AL settings; and conducted a 15-year review of recommendations for improving assisted living — made by CEAL’s predecessor, the Assisted Living Workgroup — which showed that these recommendations have made an impact in state regulations and federal policy. But we still have a lot of work to do around improving person-centered care, advancing quality of dementia care, and providing guidance to states as they continue to revise their assisted living regulations.
SSW: What excites you about this new institutional home for CEAL@UNC?
DP: What’s most exciting is that we have Dr. Zimmerman at the helm to lead it. When planning this transition, the board of directors knew we needed someone with Dr. Zimmerman’s experience, knowledge, and passion to lead the work. Her experience collaborating with other organizations as well will only make CEAL@UNC stronger in the long run. I’m proud of all the work that CEAL was able to accomplish, and I believe this new relationship placing CEAL at UNC will ensure it’s going to do bigger and brighter things than ever before.
THE BIG PICTURE
- The only national center (with a 20-year history) for advancing the well-being of people who live and work in assisted living has a new institutional home at UNC
- Has an advisory board and advisory council, including representatives from many dozens of national organizations
- Currently leading three initiatives to strengthen assisted living care via practice and policy nationwide
To read more articles in the School of Social Work 2023 Fall Impact Report, click here.
