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Nursing Home Patients Sicker Than a Decade Ago

March 21, 2005
Today's elderly population appears to have more physical and cognitive impairment than a decade earlier, according to a study by Miami (Ohio) University's Scripps Gerontology Center. The study examined detailed physical and mental assessment data on over 70,000 nursing home residents compiled in June 2004.

The report finds that on the whole, nursing home residents have more physical disabilities and more cognitive impairment than ten years earlier. As a result, the percentage of residents meeting the level of care criteria also increased, compared to 1994.

Scripps further noted that more than twice as many people were admitted to Ohio nursing homes in 2001 than in 1992, and eighty percent of the 142,000 patients discharged from nursing homes returned to their homes, most after rehabilitation therapies.

The study found that 95 percent of nursing home residents meet the nursing home level of care criteria established by the Ohio Medicaid program. Scripps researchers Shahla Mehdizadeh, Ph.D., and Robert Applebaum, Ph.D., studied the 4.5% of nursing home residents who did not meet the nursing home level of care.

Their investigation found that these individuals tended to be younger and have less family involvement than the typical nursing home resident, and 89% of them had mental health disorders.

Ohio Health Care Association (OHCA) President and CEO Peter Van Runkle said the study's findings on the residents who did not meet the level of care criteria are significant.

"These individuals predominantly have mental illnesses. They need 24-hour supervision and care, even though they may have minimal physical disabilities. They would be a danger to themselves or others if they were forced to survive on their own or with others in the community," Van Runkle said. He pointed out that there are no other viable alternatives for their care.

In 2003, the Ohio General Assembly authorized the Ohio Access Success Project, which was intended to move long-term nursing home residents back into the community. Over a year later, the $1.7 million program has relocated only five nursing home residents.

"The failure of the Access Success Project shows that there are not many of our residents - other than the rehabilitation patients we return home every day - who can be safely and cost-effectively moved out of a nursing home," Van Runkle said.

Beginning in the 1960's, Ohio's state-run psychiatric institutions were emptied. Often, the former residents became "street people." Many ended up being cared for in nursing homes, at less cost than hospitalization. There is a lack of other community-based programs for these individuals.

"Last week, an official from the Ohio Department of Aging told us these individuals would not be appropriate for assisted living communities," said Van Runkle. "There may be ways of serving some of them in settings other than nursing homes, but the state does not have the money to create all the new facilities and services they would need."

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