Nursing homes may be suffering from an image problem. The Covid-19 pandemic worsened Americans’ view of quality of care at nursing homes, but their opinion hasn’t recovered.
This is according to a recent survey conducted by West Health and Gallup on the perceptions and concerns of Americans regarding nursing homes. The survey, conducted online from July 5 to 24, collected responses from a nationally representative sample of participants.
One of the central findings of the survey indicates that Americans hold a less than favorable view of nursing home quality. Over 40% of respondents gave nursing homes negative ratings for overall quality of care, with 36% assigning them a “D” (poor) grade and 6% an “F” (fail). Only a small percentage rated nursing homes positively, with just 1% giving them an “A” (excellent) and 8% a “B” (good). The average rating for nursing-home quality of care, therefore, comes in at a disappointing D+.
The survey also revealed that a significant portion of respondents expressed discomfort with the idea of living in or admitting a family member to a nursing home. Seven out of 10 U.S. adults stated they would feel very or somewhat uncomfortable if they had to be admitted to a nursing home due to their inability to care for themselves. Similarly, 61% felt uncomfortable about admitting a relative or family member to such a facility.
The survey asked respondents who expressed discomfort with nursing homes to identify their reasons, with participants allowed to select up to three concerns from a list of eight possible factors. Quality of care emerged as the most prominent concern, with 70% of respondents citing it.
Cost was another top factor, with 49% expressing concerns. Worries about the potential negative impact on mental and emotional health were voiced by 45% of respondents. Other concerns included the fear of losing independence (34%), the desire not to die in a nursing home (28%), and worries about physical safety (27%).
When asked whether nursing homes are considered to be safe places for older adults in the U.S., only 26% of respondents believed nursing homes to be safe, while 41% thought they were not. A substantial portion, about a third, remained uncertain on the matter.
Nursing home advocates cite low funding as reason
Katie Smith Sloan, president and CEO of LeadingAge, the association of nonprofit providers of aging services, said that there is a negative bias toward aging, combined with outdated funding models and under-investment in the nursing home infrastructure, which has led to systemic, chronic undervaluing of nursing homes.
“It’s time for that demonization to end because nursing homes are an important part of our healthcare system,” she said. “We’ll always need residential care for people who cannot remain in their own home, for whatever reason.”
She added that as America’s population ages, more Americans will live with frailty, dementia or other chronic conditions that require more care than our families can provide, making the need for quality residential environment more critical.
LeadingAge’s own research reveals a different view of nursing homes from that contained in the recent Gallup poll. Gathered through an online survey of Americans ages 18 and over in July 2021, LeadingAge’s survey shows that more than two-thirds of people who have experience with aging services say it was positive, and they would recommend the services to others.
“In fact, the majority (68%) of people who have had direct experience with aging services say it was a positive experience, most often citing quality as the reason,” Sloan wrote in a press release. “Quality is also a factor in why Americans have a more favorable view of nonprofits (63%) than for-profits (47%): they believe quality at nonprofit providers is better than at for-profit providers.”
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