Nursing Home Use Declining Despite Higher Demand for Long-Term Health Care

Increasing demand for long-term health care worldwide and increasing life expectancy is creating a crisis for many families. Still, nursing home use is declining due to better care options.

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Nursing Home Use Declining Despite Higher Demand for Long-Term Health Care
5 Min Read September 29th, 2016 Updated:September 19th, 2021

With so many people living longer and the increasing need for some type of long-term health care services being high, many think this means nursing home use would be exploding. However, the exact opposite is true, and most long-term health care is delivered outside of nursing homes. 

Nursing home use is declining as the occupancy rates have steadily decreased for decades. There are several reasons, in addition to the consequences of COVID-19, that nursing home use dropped steadily for many years.  More options for long-term health care are available as assisted living facilities, memory care facilities, and in-home health options have become more popular.

More people than ever before are using Long-Term Care Insurance benefits to pay for their care, giving them many options. The top insurance companies paid over $11.6 Billion in Long-Term Care Insurance benefits in 2020, allowing families to keep their loved ones at home or better quality facilities other than nursing homes.

Beth Baker wrote in her book, "Old Age in the New Age: The Promise of Transformative Nursing Homes," There are thousands more nursing homes than McDonald's restaurants in the United States." This was a 2006 statistic. While there are still more nursing homes than McDs, the number of nursing homes is dwindling at a time when the demand for long-term care services and supports is increasing.

Long-Term Care Insurance is not the only reason for decreasing nursing home use, but the insurance allows more families with choice.

"People have never wanted to go to skilled nursing homes and the fact is that over half of all newly opened Long-Term Care Insurance claims pay for home care." 

 Jesse Slome, director of the American Association for Long-Term Care Insurance (AALTCI)

The American Association for Long-Term Care Insurance is a national trade and consumer advocacy group dedicated to long-term health care planning.

Slome says owning a Long-Term Care insurance policy (LTCi) can be your nursing home avoidance protection. Most policies will pay benefits for care in your own home as well as adult day care, assisted living, memory care as well as the nursing home.

"The number of Americans in their 70’s, 80’s and even older who live in their own home keeps increasing while the number of people living in institutional settings keeps decreasing."

"Home care is what consumers want but say the word Long-Term Care Insurance and people associate it with nursing homes. That really needs to change."

Jesse Slome 

The issue of long-term health care has become a worldwide issue. The U.S. Department of Health and Human Services says about half of us will need long-term health care at some point in our lifetime. Most people know either a family member, neighbor, or friend who needed or is currently receiving extended health care services.

People require long-term care services and supports due to declining health or a deteriorating body. An illness, accident, or the consequences of aging will often lead to an individual needing long-term health care. Don't forget the increasing amount of people being diagnosed with dementia and then require supervision.

With life expectancy increasing in the United States and the rest of the world, so does the number of years people live with ill health and old age. These extra years of life mean more years people have health or age-related issues.

A report from the International Labor Organization, a United Nations agency, showed that about 300 million people over age 65 could not easily access long-term health care when needed.

The U.N. study shows that the world would need 13.6 million more care workers to cover the needs of the elderly.

The report said that the current shortfall is primarily made up for by unpaid female family members, who often are forced to reduce their time at a paying job to care for elderly relatives, putting the entire family at risk of sliding into poverty.

In the United States, Canada, and several other countries, private Long-Term Care Insurance is affordable and available. Many take advantage of obtaining LTC Insurance coverage as part of their retirement planning. 

Still, others avoid purchasing, thinking it is either too expensive, doesn't cover care at home, or they just feel they will never need care in the first place.

The Heritage Foundation says several reasons account for why families that would be wise to buy Long-Term Care Insurance but do not buy it. Some are psychological, such as denial about the possible need for future nursing home care. Others involve a lack of knowledge of potential long-term care needs or the erroneous assumption that their other insurance or Medicare provides coverage.

Most states have federal/state partnership programs available which provide dollar-for-dollar asset protection. The Heritage Foundation says, “At its core, the incentive for the individual to purchase a partnership LTCi policy is, similar to any LTCi, to protect assets and increase personal control over care.”

The Long-Term Care Partnership Program is a collaboration between the state government and insurance companies. Under this partnership, applicants who purchase qualifying Long-Term Care Insurance policies can access Medicaid coverage while retaining assets they would typically be required to spend on their long-term health care. This is referred to as dollar-for-dollar asset protection or 'asset disregard' - What is a Long-Term Care Partnership Policy? | LTC News.

Decreasing Nursing Home Home Use Doesn't Mean Decreasing Demand

While nursing home use may be dropping, there is a greater demand for long-term health care as the country - and the world - is getting older. A lack of planning has more family members becoming caregivers despite being untrained and unprepared for the role. Many families face internal strife among siblings as they debate who will take care of Mom or Dad - Family Caregiving Often Brings Conflict | LTC News.

When someone owns a Long-Term Care Insurance policy, loved ones have the time to be family instead of caregivers. Experts suggest obtaining coverage before retirement, ideally in your 40s or 50s.

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About the Author

An LTC News author focusing on long-term care and aging.

LTC News Contributor James Kelly

James Kelly

Contributor since August 21st, 2017

Editor's Note

Affordable Long-Term Care Insurance will give you the tools necessary so you can enjoy your choice of quality care, including in-home, when you need the care. The guaranteed tax-free benefits will safeguard income, assets, lifestyle, and legacy. 

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