Survey results.

Quality of life a major concern for ALF residents

WHEN IT COMES TO GAUGING CUSTOMER satisfaction in assisted living, family members may care most about quality of care, but the residents themselves tend to focus on quality-of-life issues such as meals and activities.

That was one of the key findings in a recently released report from the Assisted Living Federation of America and ServiceTRAC titled, "The 1999 ALFA National Satisfaction Study."

The report, which also looked at independent living residents and those receiving nursing care in CCRCs, was based on 12,601 satisfaction surveys completed in 1998 and 1999 by residents, family members, and employees of 170 communities.

Other major findings:

* Family members were more satisfied with services than were residents. For example, 88 percent of family members of residents living in freestanding ALFs said their overall expectations had been met or exceeded, compared with 80 percent of the residents themselves.

* The services and features that most influence the satisfaction of assisted living residents differed from those most influencing the satisfaction of independent living residents. Likewise, nursing care residents tend to weigh the relative importance of each service area differently from the other two groups. What's more, even among assisted living residents only, priorities and expectations varied depending on the type of community. For example, food services were more important to residents of freestanding communities or CCRCs than to residents in communities that combine independent and assisted living, where activities had a greater influence on overall satisfaction.

* Responses also differed depending on age, sex, marital status, and length of stay. For example, male residents of freestanding ALFs had less of a problem with the food services than did the women; older residents rated staff less favorably than did younger residents; and a greater proportion of residents who'd been in the community for fewer than five years said their expectations were exceeded with respect to a host of service areas than did those who had lived there more than five years.

The survey probed attitudes about staff, activities, food services, housekeeping, maintenance, environment, security, administration, care, amenities, and overall community.

With respect to each category, it pinpointed if dissatisfaction is associated with the physical environment, the staff, or the service delivery process.

In addition, a "priority index" was developed to help providers gauge which areas have the most impact on overall satisfaction and therefor should be addressed first.

Margaret Wylde, president and CEO of Promatura Group and author of the study, says that "for the first time, the industry has a standardized process that will help providers measure their performance as well as compare it against some type of national industry benchmark."

Wylde says one of the most telling findings is that, "pretty much across the board, staff got positive ratings. They are caring, show concern, show respect, and are friendly." Another area that receives high marks, she says, is assisted living services. On the low end of the scale, she notes, are food and activities.

"While I don't want to minimize food, it's also an area where we all have difficulty satisfying residents over the long term. I was much more surprised to see that they don't find the activities stimulating. They see [their residences] as a quality-of-life issue, not just a take-care-of-me place."

Adds ALFA spokesperson Whitney Redding, "For me, the stand-out finding was that what tends to be the focus of family members may not be residents' focus. For anybody to do justice to their dual customers, they must understand both."