At CarePods, we are often asked why older adults go to nursing homes. I hope this blog post is helping in examining the reasons behind nursing home admissions and how to avoid them.
The History of Nursing Homes
The term “nursing home” is used to describe a variety of senior housing communities. Independent living, assisted living, memory care and continuing-care retirement communities are not nursing homes. The term traditionally refers to what the senior housing industry refers to as skilled nursing facilities.
This well-researched excerpt from RincondelRio’s website gives us some idea of the history of nursing homes in the United States.
“In 1954 the Hill-Burton Act provided Federal grants for nursing homes built in conjunction with hospitals which, unfortunately, resulted in nursing homes modeled after hospitals. In the late 50’s, SBA Loans were made available for stand-alone nursing home construction. The passage of Medicare and Medicaid in 1965 provided significant impetus to the private-industry growth of nursing homes. In the 15 years between 1960 and 1975, the number of nursing homes in the United States increased 140%, nursing-home beds increased by 302%, and revenues rose 2,000%. By 1980, 80% of all institutionalized elderly resided in commercially run nursing homes.”
Nursing homes have continued to grow well into the new century. Experts predict that by 2030, the number of people living in nursing homes will nearly double.
What Kind of Services Do Nursing Homes Provide?
Nursing home care is divided into two main categories: rehabilitative/transitional care and long-term skilled nursing care.
Skilled nursing rehab centers provide 24/7 nursing care with a focus on helping older adults rehabilitate and return home following an injury, surgery or hospitalization. These skilled nursing stays typically average 100 days or less. When these services are initiated by a qualifying hospital stay, Medicare covers the cost of rehabilitative skilled nursing services for beneficiaries.
On the other hand, long-term care services are just as they sound: designed for adults who cannot return home or to a lower care setting and need fulltime nursing care. Medicaid may subsidize long-term skilled nursing care services for certain individuals.
According to Genworth Financial, the average monthly cost for nursing home care in the United States ranged from $7,756 – $8,821 in 2019. Most often, long-term nursing care is paid for directly by the individual or by Medicaid if an individual can’t afford care.
Why Do Seniors Go to Nursing Homes?
A 2007 study by the Journal of the Medical Directors Association found that nursing home residents admitted directly from home were primarily white, female, widowed, and averaged 83.88 years of age. At admission, residents showed limited to extensive dependency on others for activities of daily living (ADL).
A diagnosis of dementia or diabetes were the most common among nursing home residents. And most residents admitted were experiencing incontinence or had suffered a fall in the previous 180 days of admission.
In addition to older adults admitted to nursing homes directly from home, a majority of nursing home residents are admitted following a hospital stay. According to AARP, older adults go to the hospital most often for the following conditions:
- Congestive Heart Failure
- Chronic Obstructive Pulmonary Disease (COPD)
- Coronary Atherosclerosis
- Medication Problems – Drug reactions of some sort led to 1.9 million hospital stays in 2008. Medications most commonly involved: corticosteroids, blood thinners, sedatives and sleep aids
- Infection – Pneumonia and Urinary Tract Infections are the most common
- Fractures and injuries due to a fall
How To Avoid Nursing Homes
No one wants their health or independence to suffer as they age. Luckily, there are simple ways we can address and manage chronic conditions to minimize the risk of hospitalization as we age.
Keep Moving! Moving a little bit every day can help lower blood pressure, maintain a healthy body weight and strengthen your lower body so you can avoid falls.
Avoid Isolation! If you or your loved one lives alone, consider bringing in senior care services that can help support your loved one’s needs AND provide them with much-needed interaction and companionship.
Minimize Medication When Possible! Medication affects older adults differently than it does younger adults. It’s important to monitor and note any side effects. Consider working with an excellent geriatric pharmacist with expertise in this field.
In conclusion, while most of us want to do all we can to avoid a nursing home stay, skilled nursing facilities offer a valuable service to those in need.
The key to avoiding a nursing home and staying healthy and independent as we age is to remain active. And to not be afraid to ask for help when you need it!
If you or a loved one needs help staying independent and secure in your home and you live in the greater Charlotte area, we can help. Contact us today!