August 3, 2001
BY
JULIE EDGAR
FREE
PRESS STAFF WRITER
CENSUS 2000 -- Fewer people are living in
Michigan's nursing homes, despite the growing numbers of folks moving into old
age, according to data from the 2000 census released this week.
The 13-percent drop in the state's nursing home population since 1990 is
most prominent in metropolitan areas: In 2000, there were 1,130 fewer nursing
home residents in Detroit, 743 fewer in Grand Rapids and 562 fewer in Flint.
Most places lost nursing home residents, with exceptions like Ypsilanti, which
went from 78 to 209 residents, and Waterford Township, which went from 112 to
274 residents.
The decline during the decade, from 57,622 to 50,113 residents, is dramatic.
It puts Michigan's total nursing home population on a par with smaller states
such as Indiana and Missouri, with populations of approximately 6 million and
5.5 million, respectively.
The reasons for the decline range from better medical treatment of chronic
age-related disease to newer housing options for seniors and a bigger emphasis
on home-based care. Michigan also offers the Medicaid waiver to about 15,000
low-income adults who buy from a menu of services, from their own home or
assisted-living residences.
"People want alternatives to nursing homes," said Mike Connors, a
spokesman for the Michigan Campaign for Quality Care, a grassroots advocacy
group for people living in the state's 450 nursing homes. "We've moved
forward in providing more in-home services."
The movement away from nursing homes -- defined by the Census Bureau as
offering continuous in-patient nursing care -- reflects the growing popularity
of assisted living, which comes in a variety of forms. All offer assistance
with daily activities like bathing and dressing, and many specialize in serving
people with dementia and offer a higher level of medical expertise.
"We've seen assisted-living facilities staffing up and offering almost
quasi-nursing services," said Bruce Rosenthal, director of media relations
for the American Association of Homes and Services for the Aging.
Along with the explosion in alternatives to nursing homes is a change in the
kind of client served by them.
Today's nursing home resident is older and sicker than 10 years ago,
Rosenthal said. Even a decade ago, few options were open to seniors who
couldn't manage on their own and didn't have the family support to stay in
their homes.
A survey by Nursing Home Statistical Yearbook found a significant drop
between 1997 and 2000 in the number of nursing home residents who could walk
with a cane or walker, and a slight rise in the number of residents needing
more assistance with basic activities like transferring from bed to a chair,
bathing and using the toilet.
And today, nursing home stays are shorter on average.
The journal Medical Care in 1997 reported that 66 percent of nursing home
residents stay three months or less. Only 10 percent stay 1-3 years.
Despite the trend, it doesn't translate to higher savings by the state. The
proportion of nursing home residents subsidized by Medicaid -- 70 percent --
has held steady for at least a decade, said Geralyn Lasher, a spokeswoman for
the Michigan Department of Community Health. She suggested that more affluent
seniors are staying out of nursing homes because they can afford the
alternatives.
Next year's state budget for nursing home care includes a very slight increase
-- from $1.05 billion to $1.06 billion.
Lasher said the state is committed to keeping people in their own homes or
in settings as close to home as possible.
Connors said he's waiting to see evidence of the commitment.
"A lot of work needs to be done, especially legislatively, for people
to get the kind of supports they want," he said. "The state spends
over $1 billion on nursing home care. Some of what needs to be done, aside from
allocating more resources, is to shift resources from the institutional model
that people don't want to community-based services the community is clamoring
for."
Contact JULIE EDGAR at 248-586-2605 or edgar@freepress.com.