December 4, 2012
Many older adults need only a little support to stay in their homes, but when that isn’t available they can end up in an expensive nursing home where they don’t need most of the available services. According to a new study, states that invest more in delivering meals to seniors’ homes have lower rates of such “low-care” seniors in nursing homes, after adjusting for several other factors.
PROVIDENCE, R.I. [Brown University] – The more states spend on home-delivered meals under the Older Americans Act, the more likely they are to help people who don’t need nursing home care to stay in their homes, according to a newly published Brown University statistical analysis of a decade of spending and nursing home resident data.
“Despite efforts to rebalance long-term care, there are still many nursing home residents who have the functional capacity to live in a less restrictive environment,” wrote gerontology researchers Kali Thomas and Vincent Mor in the journal Health Services Research. “States that have invested in their community-based service networks, particularly home-delivered meals, have proportionally fewer of these people than do those states that have not.”
After all the analysis, home-based meals, which served more than 868,000 people in fiscal 2010, emerged as the only statistically significant factor among OAA programs that affected state-to-state differences in low-care nursing home population. Home-delivered meals account for the bulk of OAA spending.
Other factors keeping low-care residents out of nursing homes in some states included a high proportion of residents receiving skilled nursing care, which provides nursing homes with higher revenues. Factors that drove more low-care residents of some states into homes included high nursing home capacity and a high percentage of residents with not-so-lucrative Medicaid funding.
“My 98-year-old granny was able to remain at home, independent in her house until she died, and we have always, even before I did this research, attributed that to Meals on Wheels,” Thomas said. “She lived four hours away from any family and refused to leave her house. We had comfort in knowing that every day someone was in her house to see how things are.”
Drivers, after all, not only bring food every day but also observe the condition of their clients. If the elderly beneficiary doesn’t answer a delivery, drivers report that. The volunteers therefore provide food and a “safety check” for many older adults.
For many seniors, especially those who don’t live with such a supportive family like the McNamaras, research shows that meal delivery is what allows them to remain where the ring of the doorbell is for their own door.
The National Institute on Aging (grant PO1AG027296) and the Agency for Healthcare Research and Quality (grant 5T32HS000011) supported the research.