Nursing Home Alternatives - Community Options Increasing in Massachusetts

The state of Massachusetts has committed itself to a "Community First" philosophy, which means that care at home or in the community is the first resort, and nursing home care the last resort. There are many options these days to help you live at home. Knowing who to talk to is the place to start.

First it's important to understand that many people do need nursing home care. But for others, nursing home care is not necessary. 24% of the people in nursing homes in the Commonwealth can eat, bath, dress, walk and toilet by themselves. Massachusetts has a very high rate of institutionalization compared to the rest of the country. In 2006, 101,300 Massachusetts residents spent some time in a nursing home. Three out of four of these people were age 75 or over, and 68% were women. About 90% of the nursing home beds in this state are occupied, compared to the national average of 84%. Massachusetts has the 14th highest number of nursing home beds per person age 85+. We have the fifth highest percentage (30.2%) in the nation of people over the age of 85 who have had at least one stay in a nursing home. At the same time, 27 other states in the country spend a greater percentage of their money on community based care than Massachusetts. The Commonwealth is slowly trying to "rebalance" how it spends its tax dollars on long term care.

Even though the number of people spending some time in a nursing home has been rising slightly, the total number of "patient days" has been falling. The bed days paid for by Medicaid fell by -17% over the past five years. This is partly because more and more people are going in for shorter and shorter stays. They are coming back out with home care supports. More people are taking advantage of short-term rehabilitation, and then returning home.

Knowing whether nursing home care is right for a loved one involves talking with your local Aging Services Access Point (ASAP) agency. Every city and town has an ASAP. These agencies have staff who specialize in counseling families on what kind of long term care they need: everything from day care programs, to new residential options. In some circumstances, the state now allows family members (with the major exception of spouses) to be paid as a caregiver. Other programs allow you to hire your own worker. You can live in the home of another person, or have care brought into your home.

Begin by checking out your options before you need them by calling Somerville-Cambridge Elder Services, the ASAP for the two cities, at 617-628-2601. To find out about options in other communities, call your local ASAP at 1-800-Age-Info, and press "3." Or go to www.800ageinfo.com and click on "Age Info Centers" to see a map covering the entire state. When you call the ASAP, ask to speak with an Information specialist, and tell him or her you want to learn about alternatives to nursing homes. They can also help you search anywhere in the country.