Citation URL: http://www.urban.org/KirstenBlack

This review of existing estimates confirms an upward trend in the number of facilities, beds, and residents in residential care alternatives to nursing homes, often collectively referred to as "assisted living." Estimates vary substantially, however, depending on the methodology and the type of data used. Key sources of differences are population included (i.e. aged, all ages); definition used to identify assisted living, and for population-based surveys that include both community and facility settings, survey-specific definitions of "facilities" and whether settings identified as assisted living are limited to those meeting the survey-specific facility definition. Greater disagreement exists with respect to trends in the number of nursing homes and users, even between estimates from the same data source.

This study explores how low-income functionally impaired, elderly persons are able to remain in the community without home- and community-based care (HCBC). We find that, while most rely on informal care and Medicare home care services, many go without needed services. In a comparison with participants, the non-participants were found to be significantly more likely to enter a nursing home. While the study cannot attribute the higher nursing home entry to the absence of HCBC services with certainty, the findings raise the possibility that an expansion of HCBC services could delay the need for nursing home care for this population. (Long, Sharon, Liu, Korbin, Black, Kirsten, O'Keeffe, Janet, and Molony, Sheila. 2005. "Getting by in the Community: Lessons from Frail Elders." Journal of Aging & Social Policy 71(1): 19-44.)

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