OBJECTIVES: To examine the relationship between living arrangements and health outcomes, and the potential variation in this relationship based on the rural or urban characteristics of the patient's residence within the context of home health care for patients with Alzheimer's Disease and Related Dementia (ADRD).

METHODS: To examine the relationship between living arrangements and health outcomes, and the potential variation in this relationship based on the rural or urban characteristics of the patient's residence within the context of home health care for patients with Alzheimer's Disease and Related Dementia (ADRD).

RESULTS: Patients in rural areas (19.8%) were more likely to live alone than those in urban areas (15.2%). Our main results based on linear probability regression models, show that patients living at home with others (coefficient: -0.02, p-value<0.001) or alone (coefficient: -0.03, p-value<0.001), were less likely to be discharged to the community compared to patients who lived in congregate settings. Also, for patients with ADRD who lived in rural areas, living at home with others (rural*home with others; coefficient: -0.02, p-value<0.001) or living alone (rural*home alone; coefficient: -0.03, p-value<0.001) were associated with additional lower probabilities of being discharged to their communities.

CONCLUSIONS: A multidimensional approach considering living arrangements to support home health care patients with ADRD could be critical to achieving better health outcomes. Furthermore, implementing area-specific target interventions could be important for improving care and health outcomes of patients with ADRD as well as reducing health disparities.