With new long-term care options beckoning, percentage of older Americans in nursing homes is declining, report says

WALTHAM, Mass. -- Despite the graying of the American population, the percentage of Americans residing in traditional nursing homes has declined significantly since the mid-1980s, according to a new report from Brandeis University. Increasingly, its author says, older Americans appear drawn to newer long-term care options, including assisted living and care provided within their own homes. While it bodes ill for the struggling nursing home industry, the trend may hearten those who have long fought the institutionalization of elders with disabilities.

The report, based on the most recent National Nursing Home Survey, appeared in the journal Health Affairs. It indicates that the percentage of Americans age 65 and older residing in nursing homes fell from 4.6 percent in 1985 to 4.2 percent a decade later, with the sharpest decline among those 85 and older. If the 1985 rate had held, the number of elders in American nursing homes in 1995 -- actually 1.4 million -- would have been closer to 1.7 million.

"Nursing homes are no longer as prominent among long-term care options as they were a decade ago," says Christine Bishop, a professor in the Schneider Institute for Health Policy at Brandeis's Heller Graduate School. "While nursing homes were the dominant long-term care option as recently as the early 1990s, new options that provide lower-level care -- such as adult daycare and assisted living -- have grown in prominence. Nursing homes have become more narrowly specialized, catering to those requiring the greatest assistance."

One result, says Bishop: residents of nursing homes are increasingly older and sicker, as elders with fewer needs seek services elsewhere. The facilities are generally now the choice of only the most severely disabled elders, signaling an about-face from the concerns of the 1980s over "misplaced elders" -- people of widely divergent disability levels who found themselves funneled into one-size-fits-all nursing homes -- to the

Contact: Steve Bradt
Brandeis University

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