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Low-Care Nursing Home Residents

Low-care nursing home residents do not require the full suite of services provided by nursing homes and may be able to live in a less restrictive environment with the aid of community support. Community-based services, such as Meals on Wheels, visiting home health aides, transportation programs, and technology-delivered health care programs, may allow older adults to be cared for and remain in a less restrictive and more appropriate setting. Research suggests providing at-home meals to 1% more seniors in every state could save more than $100 million nationally by decreasing low-care prevalence. Beyond cost, aging in place has emotional, social, and health benefits.

Measure: Low-care Nursing Home Residents, 2016 Senior Report
Measure: Low-care Nursing Home Residents, 2016 Senior Report

Why does this matter?

There were approximately 1.3 million people residing in nursing homes in the United States in 2020. Nursing homes provide housing and care for those unable to take care of themselves. However, some nursing home residents are considered low-care, meaning they require no physical assistance in bed mobility, transferring, toileting or eating. 

Low-care nursing home residents may be able to live in a less restrictive environment where they can receive less intensive care through home- or community-based services, or in alternative settings such as assisted living facilities. In a 2018 AARP survey, 77% of adults ages 65 and older said they wanted to live in their current residence for as long as possible. Aging in place has been shown to have physical, social and emotional benefits resulting in better health outcomes than nursing home residents.

Not only are nursing homes restrictive for people who do not need them, but they are also expensive compared with other care options. The cost of a private room in a U.S. nursing home averages $253 per day, or $7,698 per month.

  • Brown University, Shaping Long-Term Care in America Project, 2014

SNAP Reach

The Supplemental Nutrition Assistance Program (SNAP) is the largest federal nutrition program, helping millions of low-income Americans access food and improve economic security. More than four million low-income households with adults aged 60 and older rely on SNAP to stretch their monthly food budget. On average, senior SNAP beneficiaries received $129 per month in 2014 to help put food on the table. The Food and Nutrition Service works with states to promote SNAP; however, just 41% of eligible seniors enroll in the program, which may be due to transportation and mobility issues, stigma, and misunderstanding about who is eligible, and how SNAP works.

Measure: SNAP Reach - Ages 60+, 2016 Senior Report
Measure: SNAP Reach - Ages 60+, 2016 Senior Report

Why does this matter?

The Supplemental Nutrition Assistance Program (SNAP) is the country’s most extensive federal nutrition program, helping millions of low-income Americans access food and improve their economic security and health outcomes. Older adults received an average of $104 in SNAP benefits per month in 2019 to buy food. Despite SNAP and other nutritional aid programs, food insecurity remains a problem in the United States. An estimated 5.2 million older adults were food insecure in 2019, and this number is expected to increase to more than 8 million by 2050.

To be eligible for SNAP, households must meet certain income and resource limits. Eligibility criteria and monthly SNAP benefits vary by state

Not everyone eligible for SNAP enrolls in it. Barriers to enrollment include lack of knowledge about the program and how it works, cultural beliefs, difficulty completing an application and stigma associated with receiving social services.

A research study found that a $1 billion increase in SNAP could increase the U.S. Gross Domestic Product by $1.54 billion. SNAP may also reduce medical costs caused by food insecurity, which are approximately $687 million annually per state.

  • U.S. Department of Agriculture, Characteristics of Supplemental Nutrition Assistance Program Households, 2014

Prescription Drug Coverage

Prescription drug coverage decreases financial strain and increases medication adherence. Medicare beneficiaries can obtain Medicare Part D, a voluntary Medicare drug benefit, through two types of private plans, a stand-alone prescription drug plan or a Medicare Advantage (Part C) plan that covers prescription drugs. Medicare Part D plans vary by state in cost and coverage. Medicare beneficiaries in 2010 spent $4,734 out-of-pocket for health care spending, on average, and 11% of that was spent on prescription drugs. Prescription drug coverage is associated with a 10% reduction in nonadherence due to cost.

Measure: Prescription Drug Coverage, 2016 Senior Report
  • The Henry J. Kaiser Family Foundation, State Health Facts, 2012

Geriatrician Shortfall

Geriatricians are vital to the health of seniors in outpatient and inpatient settings. Compared with standard hospital care, seniors receiving care in special geriatric units have better function at the time of discharge, and inpatient rehabilitative services involving geriatricians result in lower nursing home admissions and improved function at follow-up. In outpatient settings, geriatricians tend to provide better medication management than other clinicians. With aging baby boomers and increasing life expectancy, the number of needed geriatricians will continue to rise. Although the American Geriatrics Society identifies a need to train an additional 1,500 geriatricians yearly, only 75 internal medicine or family medicine residents entered geriatrics fellowship programs in 2010.

Measure: Geriatrician Shortfall , 2016 Senior Report
  • American Geriatrics Society, 2015

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