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After nearly a decade of improvement, the percentage of low-care nursing home residents spiked between 2019 and 2020. Meanwhile, most social isolation risk factors improved between 2011-2015 and 2016-2020.

Low-care Nursing Home Residents

Low-care nursing home residents — those who require no physical assistance in bed mobility, transferring, toileting or eating — may be able to live in a less-restrictive environment and receive less-intensive care through home- or community-based services or in alternative settings such as assisted living facilities. Aging in place has been shown to have physical, social and emotional benefits for older adults, resulting in better health outcomes.
Between 2019 and 2020
Nationally, the percentage of nursing home residents who are considered low-care increased 54% from 9.9% to 15.2%, reaching its highest point in Senior Report history. Prior to the recent increase, the percentage of low-care nursing home residents decreased 19% from 12.2% to 9.9% between 2010 and 2019. The percentage of low-care nursing home residents increased in 49* states — 44 increased 25% or more — led by: 181% in Utah (3.6% to 10.1%), 134% in Ohio (6.8% to 15.9%) and 133% in North Carolina (4.6% to 10.7%).
Disparities in 2020
The percentage of low-care nursing home residents was lowest in Hawaii (3.7%), Maine (4.4%) and South Carolina (7.9%); it was highest in Missouri (31.3%), Oklahoma (28.3%) and Kansas (26.0%).

Risk of Social Isolation

Socially isolated older adults may not receive needed social support when experiencing stressful life events. Strong social networks have been shown to improve the management of chronic illness and physical and cognitive health among older adults.
During 2016-2020
Risk of social isolation — an index of social isolation risk factors: poverty; living alone; divorced, separated or widowed; never married; disability; and independent living difficulty — among adults ages 65 and older was highest in Mississippi (100) and lowest in Utah (1). For this analysis, risk factors were normalized on a scale of 1 to 100, with a higher value indicating greater risk. County-level risk of social isolation maps are available for download at 2022 Senior Report.
Nationally, the most common risk factors for social isolation among older adults were being divorced, separated or widowed (38.6%) and living alone (37.4%). The least common risk factor was having never married (5.9%).
Between 2011-2015 and 2016-2020
Nationally, most risk factors have improved (i.e., decreased), save for having never married, which increased 18% from 5.0% to 5.9%. Changes in living alone were not notable. Significant improvements in risk factors for social isolation among adults ages 65 and older include:
  • Independent living difficulty decreased 10% from 15.5% to 14.0%.
  • Disability decreased 6% from 36.0% to 34.0%.
  • Being divorced, separated or widowed decreased 4% from 40.2% to 38.6%.
  • Poverty decreased 1% from 9.4% to 9.3%.
Risk of social isolation worsened (i.e., increased) by five or more units on the 1 to 100 scale in 18 states, led by Alaska (33 to 47), New Mexico (77 to 89) and Oklahoma (61 to 73). Three states improved (i.e., decreased) by five or more units: South Dakota (46 to 39), Delaware (26 to 20) and Idaho (26 to 21).
*No data available for Alaska

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