In short, it's not uncommon for a person to receive home care for several months or more, followed by a two-and-a-half year stay in an assisted living facility, and nearly 60% require a nursing home stay of between nine months and just over two years. In the past, the national average was around two years. Today, the national average is approaching one year. In a study of older Americans who moved to a nursing home to spend their last months or years of life, 65 percent died there within a year, according to research by researchers at the VA Medical Center in San Francisco and the University of California at San Francisco.
The study authors used data from the Health and Retirement Study (HRS) to describe the length of stay of older adults who resided in nursing homes at the end of their lives. Kelly told me that “although this study does not address why certain demographic and social factors lead to a shorter stay, it does appear that people with greater social support at home have a shorter stay when they are admitted to a nursing home. The implication, he says, is that “we need to involve nursing home residents in planning conversations about end-of-life care and treatment preferences soon after admission. For example, while women tend to stay longer in nursing homes and assisted living facilities, they are more likely to be discharged to a home solution than men, who are more likely to move to another facility or to spousal care, if available.
Smith warns that the study did not examine the quality of life of the residents of nursing homes included in the study, nor did it relate quality of life to the length of stay, because the study authors did not have access to these variables. Kelly also explains that the findings of this study reinforce the idea that advance care planning should be done upon admission to a nursing home. People with more access to care and resources could stay in the community longer before moving to a nursing home than those with less access, Kelly explains. Most of these patients (70%) actually died in the nursing home without being transferred to another setting, such as a hospital.
In the study, which appears in the online Early View section of the “Journal of the American Geriatrics Society,” researchers found that the length of stay before death in a nursing home was associated with differences in gender, net worth and marital status.