RESEARCH INFORMATION ON INDEPENDENT LIVING
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Volume 1, Issue 8

Elderly Care Options

In the past decade, admissions to nursing homes— the typical prescription for elder care — have dropped 10% even though the number of Americans over age 75 grew by 27%.

Nursing homes are no longer as prominent among long-tem care options used to be," said Christine Bishop, a professor in the Schneider Institute for Health Policy at Brandeis University.

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,” Bishop said. “Nursing homes have become more narrowly specialized, catering to those requiring the greatest assistance."

Other options have joined nursing homes and opened up more choices for elderly people needing some form of care. For example, while just over 1.5 million people live in U.S. nursing homes, 800,000 live in assisted-living facilities in which care may be as minimal as prepared dinners.

The downside of assisted living is its high entry-level price tag. A lot of people also don’t want to take the chance of paying the high entry fee that can be forfeited un leaving the community. Also, while assisted living helps the elderly maintain independence, social interaction, transportation, and activities, it lacks regulation facilities. Services for people who have dementia, too, are not usually offered. 

Group homes and adult foster care are two more care options. Of course, a great number of chronically ill and disabled older people live at home with assistance from family members and home-health agencies. Many can live at home even with dementia or other intensive care needs by attending adult day-care centers. Others may require only assertive technology or home modifications.

That's also true in Germany where many people with disabilities live in nursing homes. This is because they don’t have support to live in the community. As an experiment to return people to the community, German researchers held training sessions in an accessible "smart house" and had technologies such as an emergency call system and adaptable cupboards.

Before program entry, an individual had to move independently in a wheelchair, transfer independently, eat without the help of another person, have enough endurance to take part, and be motivated. To aid in transition, the researchers devised independent living training in three phases starting with an assessment.

In phase two, independent living training occurred with weekly documentation and final assessments at the end of on-site training. The last phase consisted of home adaptation, follow-up visits, and documentation.

In summary, long-term care options for the elderly, include: 

    ·         assistive technology

    ·         home modifications

    ·         assisted living

    ·         group homes

    ·         adult foster care

    ·         personal assistants

    ·         adult daycare centers  

 —  Cindy Higgins, The Research and Training Center on Independent Living, The University of Kansas, 1000 Sunnyside Ave., Room 4089 Dole Center, Lawrence, KS 66045-7555, (785) 864-4095, E-mail: [email protected]. This project funded by National Institute on Disability Rehabilitation Research grant #H133A980048.

Information for this review came from the interactive Research Information on Independent Living (RIIL) database at www.GetRiil.org, which contains research summaries related to independent living with disabilities. A special effort has been made to include information that independent leaders in the field said they wanted, namely topics regarding accessible, affordable housing, effective advocacy for rural areas, effective transition from schools and nursing homes, accessible, affordable transportation, reaching underserved populations, policies that impede independent living, rural health care services, and Medicaid/Medicare regulations for durable equipment.

RIIL is a joint effort of the Research and Training Center on Independent Living at the University of Kansas and the Independent Living Research Utilization (ILRU) Program of TIRR