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In the early days of nursing homes
Nursing and retirement homes have traditionally been part of society that is as old as America itself. It's an early concept that was imported to the colonies in the 17th century by British settlers called Almshouses. Their place in society as a refuge for the poor and elderly eventually evolved into the modern-day nursing home.
The earliest models were originally called Convalescent homes and provided professional nursing care in a simple home-like setting. After the end of World War 2, these settings further evolved into privately-operated nursing homes and retirement facilities. The link between basic hospital care and assisted living had merged into an all-in-one solution for those who were retired.
By the late 1970s and early 80s, the ability to utilize Medicare and Medicaid benefits provided further financing solutions. Before this, nursing homes depended heavily on private donations and retirement savings to take care of their residents. The life expectancy of a nursing home resident has been carefully studied since signing the Nursing Home Act in 1987.
The rise of morality and assisted living
Since the 1900s, the concept of Almshouses provided little-more than shelter and food for elderly residents. Those who were retired above the age of 65 saw a 20-year gap that lived-on to be 85 or older. At that time, the national number estimated that 100,000 could live to be 85 if food and housing were provided.
Recent figures have shown in 2010, the elderly who live to be 85+ had grown to 5.5 million. Despite these numbers, the percentage of those living with chronic conditions represented 80% of a growing elderly population. Cases of heart disease or stroke fell to 50%, while diabetes rose another 50% between 1997 through 2006.
With the advancements of modern medicine and increased skilled care-takers that tripled between 1992 to 2009, elderly death rates had stabilized. By 2011 it was reported that 43.5 million caregivers tended to elderly residents 65 and older. Death rates indicate that 15.3 % of men and 19.6% of women lived to age 65 in 1990.
The number of elderly combined in 1990 represented 34.9 million that were 65+ with 2/3rds living in nursing homes. From 1950 to 2000, life expectancy living past 65 nearly tripled from 12.7 - 34.9 million from nursing home care. It can be further estimated that 1-in-4 retired Americans live past 85+ in nursing homes numbering 1.3 million in 1990.
This further solidifies that jumping to 5.5 million recorded in 2010, now represents a 20-year increase 4x the longevity rate. While the mortality rate estimates that 1,790 were aged 65-74, with another 4,472 aged 75-84, and 13,573 were 85+. These statistic numbers were calculated in 2017 and spread-out through the 1.3 million nursing home residents at that time.
As you can see, the number of elderly who were living in 2017 had dropped 4x since 2010. Thus marking a rise in morality figures that include cancer, heart disease, and chronic lower respiratory diseases. Despite the advanced care for age-related health issues, those who were 85+ have higher mortality than those who are 65.
The advancements of pharmaceutical medication and treatments
Retirement facilities all across the US represent 17,000 nursing homes and residences. This is further supported by 2.1 million retired Americans now representing 0.62% of the entire US population. It should be no surprise that these facilities are independently operated and are supported through Medicare payments and public funding.
Many of the residents of these nursing homes depend daily on the help of their health care staff. Daily activities including eating, showering, and daily living is all part of their assisted care programs. Essential medical treatment, supervision, and daily help with administering retiree medication also get provided within these nursing homes.
It also is common for these retired citizens to receive visitors including family members and friends all through the week. There have never been restrictions on this rule since this allows the nursing home staff to tend to other duties. Not until May 22nd of this year, did anyone notice changes in the life expectancy of a nursing home resident.
The recent COVID-19 results
At a time when all of Europe was 2 months into a full-lockdown, COVID-19 warnings in the US were minimal. The federal government did not prevent the spread of the Coronavirus and left these open to the state to state warnings. Those who were impacted first were people who already had poor health or a weakened immune system from recent illnesses.
The official reported results that were published on May 22nd were not only unthinkable, as they were largely unknown. It wasn't until late June and July that Americans began to see the majority of Coronavirus victims exposed. A total of 42% of the deaths directly linked to COVID-19 all occurred in nursing homes all across the USA.
This represented over 7,600 elderly retired people who had already died toward the end of May excluding infected retirees. Recent figures have shown since then, it has reached a staggering toll of 68,000 who represent retirement victims and workers. The number of infected has surpassed 402,000 across the 17,000 nursing homes in North America alone.
These numbers are still climbing as the newest August report is only 2 months after the initial report was announced. There is no way to estimate from this point what the next couple of months will reveal. As grim as this news is concerned, a greater effect on nursing home residents is not Coronavirus related at all.
Factors that affected life expectancy before COVID-19
For the last century, the elderly have fought a battle with age that includes a slew of health risks. Many of these can be treated easily through modern medication, while other treatments simply buy time. The 20-year age difference between 65 and 85 shows higher rates of mortality and physical resistance to fighting illness.
Among the most common ailments that the elderly are faced with in retirement homes include these health issues.
Dealing with poor health was related to daily food intake and general nutrition needs. At the beginning of the 1940s, Convalescent homes employed nurses that would order healthier meals to be prepared. It was part of a plan that could inspire better health for elderly residents that initially saw longevity increased.
However, these issues are complicated in those who suffer from depression, cancer, and mental health issues. Poor health is better managed with the support of retirement home staff and visiting family members. When these basic living requirements are denied or refused by elderly residents, the effort to assist them is a priority.
Smoking and alcoholism
For an aging generation that openly viewed social vice habits of the last 50 years, these are hard-breaking habits. Many retirement homes have strict rules for what is allowed and what prolongs the life of their residents further. These are rules that are determined differently at all nursing and retirement homes across America.
The state of Wisconsin has a specific law against residents smoking in any of its facilities throughout the state. But this doesn't include designated outdoor areas as many other states still allow currently. While the ability to smoke indoors is prohibited because of nationwide second-hand smoke laws, residents retreat to outdoor locations.
Drinking is an issue that is undecided across America since each facility has selective rules for allowing alcohol. Unless specified upfront, many retirement homes offer happy hour to keep their residents content. Other times, the written note from a doctor is enough to allow alcohol if it doesn't present a health issue.
Many of the millions of Americans who suffer from obesity seldom reach the age of 65 or older. That is not to say that the problem of overeating is not found within these communities. In 2008, only 26% of the new residents that joined retirement homes were overweight already.
These age groups included 65-80 years of age and have increased from 16.9% - 30.7% from 2000-2013. Among the national statistics, the average was 29% out of 1.3 million elderly residents. Because of obesity, high blood pressure and diabetes are common health risks for the elderly.
Although hypertension is linked to obesity, high blood pressure can be controlled with proper daily medication. Among those who have high blood pressure and are living in retirement homes all ranged in various age groups. From a study in 2013-2016, the results of patients were released with the following numbers reported.
Men who were 65-74 counted 40.2%, while men who were 75 and older numbered 28%. Women aged 64-74 ranked 43.5% and those 75 and older represented 32.7%. While the numbers appear lower for those 75 and older, the percentages of elderly residents are considerably lower by population.
Heart disease and cancer
Factors that lead to heart disease all follow the number 1 cause of death in the elderly. Age is a factor that also indicated the percentages of which group is more at risk. Here are the following numbers that were reported in 2010 on heart disease that led to 500,000 deaths that year.
Those who were 65-69 years old ranked 27.3%, 70-74 ranked 35.8%, and 75+ ranked 44.3%. In each case, males had higher percentages than females especially those aged 70-74 years. Men were reported to have 42.4% more than women who reported 37.2% of heart disease symptoms.
Cancer represents a wide variety of associated problems that can attack all parts of the human body. Those who are 65 and older represent 60% of the population who has recently been diagnosed with cancer. While 70% of the cancer-related deaths are linked directly to those over 65 and older.
Higher rates of heart disease, stroke, and dementia
Another issue that had affected many of the nursing home residents was an increase in health issues caused by isolation. This was the lack of proper health care which was difficult to handle for their overloaded staff workers. Among the retirees who needed continual medication for failing health, the onset of missing daily medication became common.
It was later discovered that many aging residents developed heart disease and dementia at an advanced rate. Many patients would suffer strokes due to the stress and confusion of the situation within their nursing homes. According to a recent survey compiled by the AARP Foundation, the social isolation in older adults is especially vulnerable.
Approximately one-quarter of the retired population living in retirement homes, age 65 and above, are already socially isolated. This makes up no more than 525,000 residents who have no family contact whatsoever. Added to that figure, the immediate closures and visiting restrictions of retirement homes that followed.
Chronic illness isn't as common with elderly residents who receive a regular flow of visits from family and friends. However, the American Association of Retired Persons (AARP) has concluded that isolation leads to advanced cases of chronic illness. The outbreak of COVID-19 also contributed to the mass isolation of the elderly, unable to have any kind of visitation.
Understaffed nursing homes
Another problem that soon affected many nursing homes was an issue that was already apparent before the pandemic began. Because retirement and nursing homes are not federally funded, their working staff is limited by the budget that is allowed. Each location has an annual budget based on individual factors of their resident who lives there.
It also depends on the location and budget that is paid in advance through retirees who choose better living conditions. A community retirement home located in Alabama will not have the luxury benefits that wealthy retired Florida residents would. Needless to say, the staff that is available for most nursing homes is often understaffed because of their budget.
With many nursing homes that began to witness growing numbers of residents who became sick, the workload tripled nearly overnight. With little or no budget to expand or hire extra help, most retirement home employees were forced to multi-task duties. Or in some cases, nursing home employees were overworked to the point of total exhaustion.
As the number of Coronavirus cases among rest home residents increased, the risk of infection further spread to these employees. Many staff members and employees who contracted the virus were unaffected and unknowingly spread it to others by accident. There are no official figures for the number of employees who were infected while working within these retirement homes.
Less contact from family due to restrictions
Sadly, the virus forced retirement homes to halt visitation rights by family members in attempts to keep their outbreak isolated. Some rest homes dealt with the visitation rights differently in each state using various limitations. Some families could visit relatives separated by a plastic shield, behind a glass window, or strict social distancing rules.
Not only was this problematic for retirement home residents, but it was also nearly impossible for their staff to organize visits. Some of the retirement residents were too old and frail to operate video chat on smartphones without staff help. Eventually, the visits from family were next to impossible as record numbers of residents were quickly infected.
Speaking directly to a family member living in any of the nursing homes was more of a health hazard risk. Many families were turned-away without being given any details on the status of a loved one. If a family was contacted on the status of elderly residents, it was often to inform them they had died.
Some elderly residents were not victims of the virus at all but suffered complications from other health conditions. With such high levels of illness being dealt with, the exact nature of their passing is not clearly defined. It can be understood that isolation and depression may have caused natural illnesses to speed-up existing health problems.
Other relevant factors related to age and health
Considering that retirement living is associated with the ability to enjoy the golden years, it relies heavily on the facility. Those who live with a fixed retirement income have a better selection of options, whereas others are financially limited. These are decisive factors that can also have a huge impact on the life expectancy of a nursing home resident.
Medical access and expert staff
The key element to any nursing home is a caring staff since not every resident will be in the best health. Being mobile or able to move around is from the help of a staff that makes daily activities easier. With the right choice for assisted living, it can add several years to an elderly resident unless their health fails.
Many nursing homes work closely with hospitals and make arrangements to transfer their residents to the hospital when required. This makes it easier and faster for relatives who cannot do this at a moment's notice. When a patient is released from the hospital, these residents are returned to their living community from the same staff.
Better living conditions
It's also a luxury that some residence communities offer living arrangements that are familiar to them. Retirement facilities that look more like a real home have an effect on the elderly for longevity. Rooms and living areas that feature the same kind of interior decoration they are used to seeing are vital.
This plays a role in the psychological well-being of the elderly residents, as a good facility is their 2nd home. A cold-looking retirement center has a negative effect that can lead to depression and failing health. This is why many nursing homes used the model of how convalescent homes of the 1940s and 50s were decorated.
Clean living and daily activities
An active mind is encouraged to increase the morale of an aging resident to prevent their boredom. All the activities that contribute to various models for retirement homes can include daily exercises that are mental and physical. In some cases, it's not uncommon that elements of vacation-like settings are offered such as buffets and festive celebrations.
The importance of holidays is often exaggerated to stimulate the senses and encourage being involved in these events. It all depends greatly on the location and what each state offers as a built-in service. This is why it's very important to find a retirement home that offers a complete package of life-extending perks.