Up to half of older Americans could stave off going into nursing homes if more group housing options were available, say two Cornell researchers. Although group living offers seniors lower cost housing, independence, social interaction and a wide range of household and health services, fewer than 1 percent of the elderly live in such housing.
That's according to a new study by Peter Chi, professor of policy analysis and management, and Joseph Laquatra, associate professor of design and environmental analysis.
From 10 to 50 percent of the country's nursing home population is institutionalized unnecessarily, Chi said. However, more than half of men and women 65 or older have at least one disability. Many, he says, would benefit from a group housing residence.
Group housing includes shared residences; so-called congregate housing, in which residents have their own living quarters but share at least one meal a day and may have access to organized social activities; assisted-living arrangements, in which residents may have some supervision, housekeeping services, meal preparation and intermittent personal care services; and personal care assisted-living facilities, which offer private living quarters, meals, housekeeping and continuous personal-care services.
"Group housing offers tremendous advantages to older Americans, from companionship and affordability to assistance in daily living chores," said Chi.
Although very few older Americans live in such settings, the researchers found that in counties where group housing is available, fewer seniors choose to live in nursing homes.
"Since the size of the elderly population is going to increase dramatically in the coming decades, more group housing options are urgently needed in American communities to minimize the inappropriate placement of older persons in nursing homes that are too intensive and too expensive for them," Chi said.
Chi and Laquatra analyzed data on people 65 or older in 816 metropolitan counties and 2,129 non-metropolitan counties from U.S. Census data called USA Counties, 1996.
They found that up to 95 percent of these older Americans live in their own homes, regardless of region or metropolitan status, and about 5 percent live in nursing homes. Less than 1 percent live in group housing, but "just a modest increase of up to 5 percent would mean a tremendous savings in long-term health care expenditures," Chi said.
Group housing, the researchers found, is more likely to be available in affluent communities with more physicians and higher educational levels. Communities that are least likely to offer group housing tend to be rural with low per-capita income and older residents forming 12 percent or higher of the population.
Chi and Laquatra recommend that adjacent counties, perhaps ones with greater resources pairing with ones with fewer, form strategic alliances to develop group housing. Communities should offer such housing options, they say, as well as moving assistance and counseling services to help the elderly adjust to group housing.
"We need a turnaround in thinking to give our aging population a larger middle ground of group housing options that offer a high but affordable quality of life. That turnaround requires a shift in thinking from individualism to collectivism and from independence to interdependence," Chi said.
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