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States' Spending may Help Keep Childless Seniors Independent

Seniors who do not have children to help care for them are less likely to have to go into a nursing home if they live in a state that spends more on home- and community- based services, researchers have found.

Researchers at the University of Illinois at Chicago report the finding in the May 11 issue of the Journals of Gerontology: Social Sciences.

"Traditionally, long term care has been provided in nursing homes, but there is a movement to help older people live at home and in the community," said Naoko Muramatsu, associate professor of community health sciences at the UIC School of Public Health and lead author of the study.

"States vary greatly in their commitment to provide home- and community- based services such as personal care, adult day care, nutrition, and transportation," said Muramatsu, a researcher in UIC's Institute for Health Research and Policy. "There has been little evidence, prior to this study, to show that spending more money on these services helps seniors avoid or delay placement in a nursing home."

Some states spend as little as $35 per person each year on home- and community-based services for seniors, while other states spend more than $1,300 per person annually, according to previous research.

Regardless of how much was spent on home- and community-based services, the researchers found that doubling states' spending on services would reduce the risk of nursing home admission among childless seniors by 35 percent.

Using data from a national survey of first long-term nursing home admissions occurring between 1995 and 2002, the researchers examined how variations in state spending affect risk of nursing home admissions and whether the effect is different for those who have family and those who do not.

They found that higher state spending on home- and community-based services was associated with a lower risk of nursing home admission for the chi ldless but not for those with children.

"Our research suggests it is important to invest in home- and community-based services for disabled seniors," said Muramatsu, "however, policy makers should give careful consideration to fairness and cost-effectiveness of resources. Many seniors, regardless of whether they have family support, prefer to live in their community as long as possible."

Given the aging baby boom generation and concerns of families caring for aging parents, the researchers caution that further research is needed to determine how to allocate limited long-term care resources in the United States.


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