Tag Archive for: Aging in Place

Study: PACE participants with disabilities experience fewer SNF admissions

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This article was originally published on McKnights Home Care.

Adults with disabilities who participated in the Program of All Inclusive Care for the Elderly (PACE) reported satisfaction with their care and spent fewer total stays in skilled nursing facilities (SNF) compared to nonparticipants, according to a July study published in Archives of Physical Medicine and Rehabilitation.

“Our results are relevant to the evolving healthcare landscape,” authors said. “PACE’s intensive care management, day care and transportation services may outweigh the broader provider choice of traditional managed care. Patient outcomes and cost data are central to advocacy for PACE sustainability. Yet PACE is offered at states’ discretion and is not a mandatory Medicare/Medicaid benefit; under fiscal pressure, programs often struggle to maintain adequate rates and grow enrollment.”

The study examined data on 51 PACE participants with disabilities between the ages of 56 and 68 who were assigned to participate in the Community LIFE PACE program in the Pittsburgh, PA, area. Researchers tracked health outcomes by assessing each participant’s function, quality of life, mood and community participation. Meanwhile, they self-assessed their own care experience using the Patient Assessment of Chronic Illness Care (PACIC). Cost and utilization outcomes included number of emergency room (ER) visits, costs of ER visits, SNF length of stay as well as costs associated with SNF stays.

The results showed that, over the course of the study, three participants were admitted to SNFs for a total of 468 days at a total cost of $126,447. With regard to satisfaction with care, the overall PACIC scores continued to indicate high satisfaction (>80%) with care throughout the study period, but there were no consistent trends observed. PACE participants also had more ER visits, more hospitalizations, higher hospital lengths of stay and fewer outpatient visits compared to the control group, but authors note that this was likely affected by a small number of outliers overutilizing care.

Integrating Care for Aging Populations: Dual-Framework Policy Analysis of the United States Program of All-Inclusive Care for the Elderly (PACE)

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This article was originally published on Journal of Advanced Nursing.

ABSTRACT

Aim

To critically analyse the federal Program of All-Inclusive Care for the Elderly (PACE) using the Integration Continuum Framework and the Conceptual Model for Nursing and Health Policy, identifying system-level strengths, equity gaps and nursing implications for long-term care reform.

Background

The U.S. long-term care system remains fragmented and institutionally biased, disproportionately affecting dual-eligible older adults who account for outsized healthcare expenditures despite comprising just 17% of Medicare beneficiaries. Permanently authorised under the Balanced Budget Act of 1997, PACE delivers fully integrated, community-based care for individuals aged 55 and older who qualify for nursing home-level services but prefer to remain in their communities.

Design

A policy analysis guided by dual conceptual frameworks assessing PACE structure, implementation and impact across four policy outcome levels: efficacy, effectiveness, equity and justice.

Methods

This policy analysis was conducted between May and July 2025. Two conceptual frameworks were applied to examine PACE structure, implementation and outcomes. Data sources included peer-reviewed studies, federal legislation, policy documents and grey literature published between 2020 and 2025, supplemented by international integrated care literature.

Findings

PACE demonstrates strong efficacy and effectiveness, with fully integrated interdisciplinary teams and reduced institutionalisation for enrolled older adults. However, the program falls short on equity and justice due to limited geographic reach, racial and ethnic disparities in enrollment, exclusion of Medicare-only populations and persistent nursing workforce challenges.

Conclusion

PACE exemplifies a high-functioning integrated model of community-based long-term care, but current policy constraints prevent it from achieving scale and equity. Without eligibility expansion, financing reform and workforce investment, its transformative potential will remain unrealised. Nurses are central to this vision and must be empowered as clinical leaders and policy advocates to sustain care coordination and advance health equity in aging populations.

Aging in Place Statistics and Facts in 2024

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This article was originally published on Forbes Health.

For older adults who prefer to age in place, making safety modifications to their home or downsizing to a residence that requires less maintenance and features fewer mobility barriers can be a crucial decision. Aging in place successfully requires careful planning, and oftentimes, a caregiver, social support system and consideration of potential future health issues, such as heart disease, diabetes and cognitive decline.

The following statistics and facts may be helpful to consider if you or a loved one wish to age in place and can help inform decisions surrounding home modifications and lifestyle choices.

Read more online…

Survey: One in Four U.S. Older Adults Needed Long-Term Care for Themselves or a Loved One In 2022

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This article was originally posted on Nexus Insights. Read the full article here.

Results

Twenty-four percent of U.S. adults ages 50 and older say they, or a loved one needed long-term care in the past year, according to a new, national survey.

According to the survey findings, most older adults said the process of selecting long-term care caused anxiety (53%) and frustration (52%), while few said they felt confident (23%), at peace (23%), or happy (14%) while making a choice.

Finally, the survey respondents said it was extremely important to have additional information about the cost of care and options to pay for it (69%) and the different types of long-term care services available (63%).

The findings illustrate the widespread need for information and guidance about long-term care services among an aging population and their caregivers, a need that experts say will grow exponentially in the future.

Background

Nexus Insights released a report earlier this year detailing the often frustrating and confusing process facing many older adults when making decisions about long-term care for themselves or a loved one. It called for a national long-term care navigation hub to help older adults discover and assess options, educate them on available support and funding, select and connect with the option that is best for them, and continuously evaluate their needs as health and financial statuses change. Navigation resources are needed immediately to support the aging Baby Boomer population, many of whom not only serve as caregivers to older parents but will soon need long-term care themselves.

Methodology

The poll was conducted between November 11 and 14, 2022, during a monthly Omnibus survey. It included 1,014 interviews with a nationally representative sample of adults age 50 and older (margin of error +/- 4.34 percent points). The AARP and NORC’s Foresight 50+ probability-based panel is designed to be representative of U.S. adults age 50 and older.

Most People Want to Age in Place, but Few are Aware of the Services Available to Support Them

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This article was originally posted on Cross Country. Read the full article here.

Despite the rapid acceleration of aging in the U.S., the study findings present a surprising lack of awareness of in-home care options for Americans aged 50 years or older. Fewer than one in 10 respondents are actively looking into care. More than one-third (34%) have not thought about their care needs as they get older. There are dramatically low levels of awareness for existing in-home care options like PACE, with four out of five respondents having no awareness of these services. And given a choice, most respondents (70%) would prefer to continue to age in place at home with support.

Cross Country Workforce Solutions Group surveyed i 500 U.S. people to gauge how those aged 50 years or more are preparing for the care they will need as they grow older. We learned that awareness of existing in-home care programs, such as PACE (Programs of All-Inclusive Care for the Elderly) and LIFE (Living Independence for the Elderly), was low among the survey respondents, regardless of age group. Eighty percent of the total respondents had not heard of either program.

PACE is a Medicare program for older adults and people over the age of 55 who are living with disabilities. It provides community-based care and services to people who otherwise need a nursing home. Ninety-five percent of PACE participants live in their community. The average age is 77, with 69% female and 31% male. PACE was created to provide participants, their families, caregivers, and professional health care providers flexibility to meet a person’s health care needs and help them continue living in their community.

Needs Vary for Managed-At-Home Services

The respondents reported that being taken to appointments (45%) and getting medically necessary care (45%) were the two most popular in-home care services. Shopping (36%) was reported as third, slightly ahead of meal preparation (33%) and laundry (32%). Twenty-seven percent of respondents said they are not interested in receiving any services. This finding jumped to 44% for respondents aged 60 to 79 with less than $50,000 and 41% for non-white respondents in the same age group. When asked what else they would be interested in if the services weren’t listed in the survey options, the most common responses were general housework and cleaning.

Most respondents (40%) would prefer afternoon care; few respondents prefer evenings or around-the-clock supervision. The plurality of respondents would select care one or two days a week, although many would like care three or four days a week.

Costs Drive Decisions About In-Home Care

Costs are the most critical consideration in assessing in-home caregiving services, regardless of age (73%). Background checks on the care providers ranked second (66%), followed by the skill levels and services available (58%). Personally selecting care individuals who would do home visits was more important to people in their 50s (56%) than other age groups. Respondents in their 70s were more concerned (61%) about the carers’ skill levels and the hours that help is available (56%) than any other age group.

When asked what information sources they would rely on to explore opinions on possible in-home caregiving services, the participants cited friends and family (58%), online searches (58%), and their doctor (56%) as the primary sources.

Despite the rapid acceleration of aging in the U.S., the study findings present a surprising lack of awareness of in-home care options for Americans aged 50 years or older. Fewer than one in 10 respondents are actively looking into care. More than one-third (34%) have not thought about their care needs as they get older. There are dramatically low levels of awareness for existing in-home care options like PACE, with four out of five respondents having no awareness of these services.

Who Can Join A PACE Plan?

You can join PACE if you meet the following conditions:

  • You are 55 years old or older.
  • You live in the service area of a PACE organization, and there are currently over 270 PACE Centers across the U.S.
  • You are certified by the state in which you live, meeting the need for the nursing home level of care.
  • You can live safely in the community when you join with the help of PACE services.

Our Thinking

We believe that when a choice is an option, in-home care is the best solution to help seniors age in place. Home healthcare provides an alternative that can offer more independence while optimizing individual care for many. It recenters their healthcare around their life, rather than their life around healthcare. That’s the way it should be.