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Senior Citizens and the Elderly
Seniors make up a majority of the residents in assisted living

People living in assisted living

As a person ages, friends and family visit more often to check on the aging relative and loved one. As an older adult's health declines and becomes frail, worry heightens for the family. They know if a slip occurs in the kitchen or on a wet bathroom tile, its disastrous without immediate intervention.

As family worry escalates, discussions begin around care options. At first, none are appealing, especially to the older adult. As time passes, the relative needs more and more attention and help. Mom needs help getting dressed, getting in and out of the tub, help with cooking, and keeping doctor's appointments.

Even though she may not need help around the clock, she needs someone to keep an eye on her more often than once a day or week.

The Solution - Assisted Living

Assisted living gives the type of care that's between independent living and around-the-clock care of a nursing home. It's for older people who value independence, yet require some help with life's daily chores and necessities.

In a 2013 study by the National Center for Health Statistics, more than 8 million people in the United States composed of mostly women 65+ and older used the services of a long-term care provider in 2012.

Based on the 58,500 paid, regulated long-term care services; the providers delivering the services are:

  • 4,800 adult day services centers,
  • 12,200 home health agencies,
  • 3,700 hospices,
  • 15,700 nursing homes,
  • 22,200 assisted living and residential care communities.

Each day in 2012, there were 273,200 participants enrolled in adult day services centers, 1,383,700 residents in nursing homes, and 713,300 residents in residential care communities; in 2011, about 4,742,500 patients received services from home health agencies, and 1,244,500 patients received services from hospices.

Aging Care Needs

The supply of assisted living facilities and residential care homes were comparable to the number of nursing homes in the western United States. Residential care communities were more prevalent in the Midwest and West than in the Northeast and South.

The study confirmed that most residents pay out-of-pocket for assisted living with a small percentage using Medicaid to pay for services. In contrast, the largest payer for a long-term nursing home is Medicaid while Medicare finances hospice costs and a major portion of the costs for short-stay, post-acute care in skilled nursing facilities for Medicare beneficiaries.

Breakdown of Needs by Age

Care Needs by Age Group
Care Needs by Age Group

Although many people of different ages need long-term care help, the risk increases with age.

Over two-thirds 65 and older need long-term care services, due to aging baby boomers. It estimated 41+ million people needed long-term care in 2010 and now forecasted to grow to 88.5 million by 2050.

The 85+ age group projects to triple in growth, from 6.3 million in 2015 to 17.9 million in 2050 (U.S. Census Bureau, 2012).

Nursing Homes vs Assisted Living

On average, a nursing home served more than twice the number of people daily as a residential care community. It housed an average of 88 current residents while a residential care community served an average of 32 residents daily.

Most of the nursing homes (61.7%) served between 26 and 100 residents daily while most of the residential care communities (59.9%) served 25 or fewer residents daily. Nursing homes (32.8%) served more than 100 persons daily which was about six times as large as the assisted living and residential care communities at (5.5%).

In a study conducted by the Center for Disease Control in 2010, key findings illustrated that persons living in state-regulated residential care facilities, assisted living communities, received housing and supportive services because they cannot live independently but generally do not require the skilled level of care provided by nursing homes. Previous estimates of residents in assisted living depended on the care home's definition. The recent National Center for Health Statistics shows that for each day in 2010, 733,300 persons resided in assisted living facilities nationwide.

Data from the 2010 National Survey of Residential Care Facilities

Characteristics of Residents
Characteristics of Residents

Characteristics

  • Most of the residents living in residential care facilities in 2010 were non-Hispanic white and female.
  • More than one-half of all residents were 85 years of age and over.
  • Nine in ten residents were non-Hispanic white (91%), and seven in ten residents were female (70%).
  • More than one-half of residents were 85 and over (54%), and more than one-quarter of residents were 75-84 (27%). The remaining one-fifth of residents are evenly split between those aged 65-74 (9%) and those under age 65 (11%).
  • A medium length of stay among all current residents at the time of interview was 671 days or about 22 months.

Medicaid Beneficiaries

  • Nearly 2 in 10 residents were Medicaid beneficiaries, and almost 6 in 10 residents under age 65 had Medicaid.
  • Medicaid paid for at least some of the residential care facility services for 19% of residents.
  • Younger residents were more likely to have Medicaid than older residents. Almost 6 in 10 residents under age 65 had Medicaid (56%) compared with 39% of residents aged 65-74, 16% of residents aged 75-84, and 10% of residents aged 85 and over.

Activities of Daily Living

  • Almost 4 in 10 residents received assistance with three or more activities of daily living, of which bathing and dressing were the most common.
  • About three-quarters of all residents received assistance with bathing (72%), over one-half received assistance with dressing (52%), more than one-third received assistance with toileting (36%), one-quarter received assistance with transferring (25%), and more than one-fifth received assistance with eating (22%).
  • Thirty-eight percent of assisted living residents received assistance with three or more of these activities of daily living, an additional 36% received assistance with one or two of the activity needs, and 26% did not receive assistance at all.

Chronic Conditions

More than three-fourths of residents have had at least 2 of the 10 most common chronic conditions; high blood pressure and Alzheimer's disease and other dementias were the most prevalent. The 10 most common chronic conditions among residents:

  1. High blood pressure (57%),
  2. Alzheimer's disease or other dementias (42%),
  3. Heart disease (34%),
  4. Depression (28%),
  5. Arthritis (27%),
  6. Osteoporosis (21%),
  7. Diabetes (17%),
  8. Chronic obstructive pulmonary disease and allied conditions (15%),
  9. Cancer (11%),
  10. Stroke (11%).

More than one-quarter of Residential Care Facilities' residents diagnosed with 4-10 of the most common chronic conditions (26%); one-half of residents diagnosed with 2-3 of the most common chronic conditions; 18% diagnosed with one of these chronic conditions; and the remaining 6% been diagnosed with these conditions.

Source: The Center for Disease Control

Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.