Utility of the Maryland assisted living functional assessment tool

The purpose of this study was to consider the utility of the Maryland Assisted Living Functional Assessment (MALFA) in terms of predicting successful living in an assisted living facility. Consideration of utility of this tool was based on the predictive ability of the measure at baseline to explain length of stay and level of care needed for residents (nursing home versus assisted living) over a five year period. A total of 76 residents from a single ALF in the Baltimore area were tested annually over five years. Those who transitioned to a nursing home at some point during the 5-year period (47%) had higher mean scores on admission with regard to need for nursing interventions because of cognitive and psychiatric problems or to perform medical treatments. Medical illness influenced number of years in assisted living and accounted for 7% of the variance (F = 7.2, p < .05). The assessment tool provides a wealth of information about the resident and can be used to alert providers to consider individuals with high scores in subscales such as need for monitoring of cognitive and psychiatric problems or need for medical treatments in terms of being at risk for nursing home placement. Future work should consider how to optimally use the MALFA to implement interventions in assistive living that will prevent decline in areas that seem likely to result in a need for a higher level of care.