TRENDS IN HOME CARE-GIVING
A recent AARP study of current trends in home care-giving of older persons has presented some interesting results. (FN1) First, the number of older persons over 65, with disabilities has actually declined between 1984 and 2004. Even though the number of older persons has increased, the disability rate of those elders has declined. The total disability rate decreased among all age groups in the population of persons age 65 and over. Details of the decline indicated that persons in the age category 75-94, for example, had less trouble with four or five Activities of Daily Living (ADL's), than before. In other words, persons in this age bracket were reporting fewer categories of difficulty as they went about their daily routines.
Secondly, there was a significant decline in the use of institutions, such as nursing homes, by older persons. Savings for the Medicaid program were estimated to be roughly $24 billion dollars.
Thirdly, the correlation is that there is an increase in the number of older persons with disabilities thst are living in the community. That number, according to the study, increased by two-thirds between 1984 and 2004. Furthermore, the growth in the older population living in the community with disabilities was especially strong among the oldest age groups.
The fourth trend noted by the AARP study is that the gender gap in disabilities is growing. Disability rates have been lower and have declined more among older men than among older women. And additionally, three-fourths of the growth among persons living in the community with two or more disabilities, was among women.
The fifth trend appears to be that married couples are not as likely to live in an institutional setting, and that they are less likely to have a disability. Being married apparently has more benefit than simply being a good financial move. A much higher percentage of married persons were able to live in the community with 2 or more ADL disabilities. As a matter of fact, disability rates were much lower for married respondents than for widowed or other unmarried respondents throughout the entire 20 year period.
Trend six has to do with the increased numbers of older persons who made assisted living facilities their home. While the number of older persons living in institutions (considered to be nursing homes or other long-term care facilities) declined 11%, the number of older persons with disabilities living in community residential care facilities increased some 74%. A community residential care facility has many forms, but is often considered to be an assisted-living type facility. The number of older persons with disabilities living in a private residence with others increased about 12%. Overall, it appears that some form of assisted living may be replacing nursing home care for a segment of the older population with disabilities.
The final trend noted in the AARP study found that the growing numbers of older persons living in the community with disabilities have low incomes. Three out of five older persons living in the community with two or more ADL disabilities reported annual incomes of less than $20,000.00.
FN1: More Older People with Disabilities Living in the Community: Trends from the National Long-Term Care Survey, 1984-2004, Donald L. Redfoot and Ari Houser, AARP Public Policy Institute, September 2010