Despite the graying of the nation, the percentage of elderly living in nursing homes has declined, according to Census data released today. The downturn reflects the improved health of seniors and more choices of care for the elderly.
About 7.4 percent of Americans aged 75 and older lived in nursing homes in 2006, compared with 8.1 percent in 2000 and 10.2 percent in 1990.
"The upper-income white population has other options than nursing homes," says William Frey, demographer at the Brookings Institution. "They're moving to assisted living or their well-off, baby boomer children are taking care of them in other ways."
At-home care and assisted-living facilities have been a fast-growing segment of elder care in the past decade, says Elise Bolda, director of Community Partnerships for Older Adults, a Robert Wood Johnson Foundation program that helps communities develop long-term care and services for the elderly.
More than 1.8 million people live in nursing homes.
The percentage of the oldest age group of seniors living in nursing homes has been dropping. Less than 16 percent of the 85-plus population was in such facilities in 2006, according to the Census. In 1985, more than 21 percent in that age group lived in nursing homes, according to the National Nursing Home Survey, a government study.
"This is good news, given this is the age group most likely to need the assistance and the fastest-growing group in our population," Bolda says.
The Census data on people who live in "group quarters" — including nursing homes, college dormitories and prisons — provide the first detailed profile of those populations since the 1980 Census.
The nursing home numbers do not include assisted-living facilities. "There's no federal definition of assisted living and that's a void in the data," Bolda says. "Fortunately, communities are taking responsibility for addressing the needs of older adults rather than waiting for federal policy solutions."
Caring for the elderly is a major policy concern now that the oldest of 79 million baby boomers turn 61 this year. The number of people over the age of 65 will nearly double by 2030 to about 71 million.
The average cost of nursing home care is more than $67,000 a year and tops $100,000 in some urban areas, according to the 2006 MetLife Market Survey of Nursing Home and Home Care Costs.
"Given the high cost of nursing home care coupled with older adults' desire to age at home, communities will need to ramp up the availability of home and community-based service options," says Sandy Markwood, CEO of the National Association of Area Agencies on Aging. "If you can keep people in that 65-to-74 age group out of nursing home facilities, it's a significant improvement."
The average nursing home patient runs out of money within six months and must go on Medicaid, Markwood says. That, she adds, "will not only bankrupt individuals but also the Medicaid system."