Articles
Nursing Homes
October 26, 2000
Nursing homes account for the greatest share of public and private spending on long-term care (about 70%). A nursing home is a residence that provides room, meals, recreational activities, help with daily living, and protective living independently. Nursing homes are certified to provide different levels of care, from custodial to skilled nursing (services that can only be administered by a trained professional).
Studies, such as the following, document the likelihood of nursing home use, reliance on Government funds, and characteristics of users:
- About 43 percent of persons turning age 65 will use a nursing home before they die. About 20 percent of users will spend 5 or more years there (Kemper and Murtaugh, 1991). Of those turning 65, 17 percent can expect to use a nursing home and receive Medicaid reimbursement (Spillman and Kemper, 1995).
- More than 70 percent of nursing and personal care home residents are women and two-thirds of them are widowed or divorced. About 40 percent are demented and about 59 percent require assistance with four or more Activities of Daily Living (ADLs) (Lair and Lefkowitz, 1990).
- About 10 percent of residents in nursing and personal care homes are under age 65 (Lair, 1992) and 11 percent do not need help with ADLs (Lair and Lefkowitz, 1990).
The Agency for Health Care Policy and Research projections show that 4 out of every 10 older people will stay in a nursing home at least once, and nearly 1 in 10 will stay for 5 or more years.
- About 20 percent of the elderly living in the community (5.4 million persons) in 1987 had difficulty with at least one instrumental or basic ADL (Leon and Lair, 1990). About 4 million of these persons need human help with these activities (Stone and Murtaugh, 1990). About one-fourth of those needing human help are cognitively impaired, and about one-half receive help with just ADLs (Spector, 1991).
- A conservative estimate is that 15 percent of nursing home residents could be cared for at lower levels of care (Spector, Reschovsky, and Cohen, 1996).
- About one million persons aged 65 and older living in the community would be eligible under criteria of needing active or standby help with three or more ADLs. The number would increase as much as 70 percent if eligibility were included for cognitively impaired persons, depending how that was defined (Spector, 1991). Other criteria are also potentially important, such as the need for complex medical treatments (Kemper, 1992).
