There’s one age group that’s going into nursing homes at a higher rate. And it’s not the elderly.
Young people ages 31 to 64 now make up 14 percent of the nursing home population, an analysis of federal data from the Department of Health and Human Services by NPR’s Investigative Unit found. That’s up from 10 percent just 10 years ago.
The data do not show why this age group is entering nursing homes in such higher numbers, but Michelle Fridley’s fight to stay out of a nursing home may provide a clue.
Ten years ago, Fridley was nine months pregnant and 23 when, driving on a rural road in upstate New York’s Amish country, she came over a blind hill and swerved to miss a horse and buggy. Her car hit a tree; she was left a quadriplegic.
At the time, Fridley was driving home to decorate for her baby shower. Her daughter, Felicia, was born nine days later. Ever since, Fridley, who is now 33, has fought to stay out of a nursing facility and continue living in her own home.
Fridley and her daughter now live in their own apartment — but only because a New York state program pays for Fridley’s personal care attendants.
“Attendants are my arms and legs. I wouldn’t be able to do anything without my attendants. They help me to get bathed in the morning. They get me dressed. They attend to my, both my, you know, urinary and bowels; my personal needs. They help me to cook. They drive me from doctors’ appointments to wherever I need to go, and I like to get out,” Fridley said.
Since her injury, there have been three times when she almost went into a nursing home. One came earlier this year when officials in New York proposed cutting the attendant care program. After Fridley and others protested — and she told her story to New York Gov. David Paterson — the decision was reversed. However, more state cuts are expected next year.
According to a study by the AARP Public Policy Institute, the cost of attendant care is about a third the cost of providing care in a nursing home or institution. But there’s an upfront cost to states to hire the case managers and aides, find the housing, and pay for other things that make this home-based care work. And states worry that more people — who now depend upon family to provide the care to keep them out of nursing homes — will start demanding this care at home.
So as states face record budget gaps, the programs that help people live at home are cut.
Nancy Miller, at the University of Maryland, Baltimore County, thinks that may be one reason the percentage of 31- to 64-year-olds is growing in nursing homes. Miller, an associate professor in the school’s department of public policy, has been studying why young people enter nursing homes and published several reports documenting these data. She has found that it’s also this same group going into nursing homes at higher rates. It’s a trend she has found in almost every state over the past 10 years.
“They were much more likely, relative to their older counterparts, to have a diagnosis of diabetes and renal failure,” Miller said. “And then I also found that a substantial share came in with a mental health problem.”
We will have more on NPR’s special series, Home Or Nursing Home: America’s Empty Promise To Give Elderly, Disabled A Choice
About This Series: There’s been a quiet revolution in the way the elderly and young people with disabilities get long-term health care. A new legal right has emerged for people in the Medicaid program to get that care at home, not in a nursing home.