Factors Leading to Nursing Home Use

In July 2010 the Mathematica Policy Research, Inc. funded by the Administration on Aging published an Issue Brief on Aging in Place: Do Older Americans Act Title III Services Reach Those Most Likely to Enter Nursing Homes? Title III programs include congregate and home delivered meals, case management and homemaker programs among others. In their study they identified the follow factors as leading to increased risk of nursing home entry:

1. Demographic characteristics: Older individuals and those who are non-Hispanic white
2. Socioeconomic status: Individuals with low incomes
3. Health status and physical functioning: Those with certain health conditions (such as cognitive impairment, cancer, high blood pressure, diabetes, and a history of strokes and falls) and those who have difficulty performing activities of daily living
4. Prior health care utilization: Individuals who have spent time in the hospital or in a nursing home
5. Living arrangements and family structure: Those who live alone (including widowed and divorced individuals), do not own their home, and have fewer children than their peers not in nursing homes
6. Availability of support: Individuals who lack caregiver support

Overall, nursing home utilization and stays are declining with increased short term stays for medicare services. Growth of home and community based services continues as older persons avoid nursing home care at all costs. How are you transforming your program to prepare for the future?