A new study examined disabilities and caregiving before and after older adults entered long-term care communities. The researchers found that people who went into nursing homes and assisted living communities, specifically, had a higher level of disability and needed more caregiving.
The researchers wanted to describe the level of disability along with caregiving needed before a person went into a long-term care facility. The team also wanted to assess how the older adults fared after they started living in a facility. Specifically, the researchers looked at disability and caregiving levels four years before a person went to the facility, and two years after they relocated. The study was published Monday in JAMA Internal Medicine.
Data came from the National Health and Aging Trends Study, and it covered 932 people from 2011 to 2020. All of the people were living in the continental United States, and they were all Medicare beneficiaries. The mean age at entry was 84 years old, and 64% of the people were women. Of all the participants, 49% had dementia. Also, 34% entered nursing homes, 45% went into assisted living and 21% moved to independent living communities.
People who went into nursing homes and assisted living communities had more severe disabilities and needed more care months before they moved. Before relocating, 49% of people who went to nursing homes and 10% of people who went into assisted living had severe disabilities. More than 97% of them had a caregiver; of all of the people who went into nursing homes and assisted living communities, 33% had a paid caregiver. The caregivers were there a median of 27 hours per week for people who went into nursing homes, and 18 hours for people who went into assisted living communities. Less than 2% of people who went into independent living communities had severe disability; their median of care was seven hours a week before and after entry.
Upon entry to nursing homes and assisted living communities, severe disability rose to 89% and 28% respectively. Less than 1% of people in independent living communities didn’t have severe disabilities four years before moving and two years after.
Caregivers largely stayed involved after an older adult entered into a long-term care arrangement. The average resident received approximately 8 to 10 hours of care a week from people who weren’t on staff at the facility.
Overall, older adults often enter nursing homes and assisted living communities (compared to independent living places) after months of severe disability and substantial help at home, usually from unpaid caregivers. Assisted living residents relocate for professional help when they are less disabled compared to people who go into nursing homes, but approach levels of disability similar to people in nursing homes who have been there for two years, the data showed.
