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Budget Cuts, Strict Regulations Keep Many “Trapped” in Nursing Homes

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A just-published investigation in the New York Times revealed a startling and disturbing fact. Of the estimated 1.4 million Americans living in nursing homes, many could thrive living elsewhere with some basic home help, but are unwillingly confined to the institutions where they live. In some cases this situation has persisted for decades.

We encourage you to click here for this eye-opening article. It profiles several nursing home residents of varying ages and health conditions who find themselves unable to move out, even though they could function well living at home or in a group home setting. This is in spite of a Supreme Court case from two decades ago that ruled that disabled people receiving public support were entitled to live in their communities instead of an institution unless greater independence were medically impossible. For example, the Times article spotlights one 53-year old patient named Marvin Dawkins who lived in a nursing home against his wishes for 11 years. “Because of budget cuts, inflexible rules, a patchwork of programs and a widespread failure to bolster alternative care, [patients] like Mr. Dawkins describe feeling stuck in deeply unsatisfying, sometimes miserable, settings.”

In Mr. Dawkins’ case it took a lawsuit and continued battles with Medicaid officials to finally allow him to live on his own with some home health care. Today he is even able to hold down a job. Now instead of lying in a nursing home watching television, he “socializes with new friends and old ones, and revels in his freedom.”

No one knows just how many of the 1.4 million nursing home resident could live more affordably and more happily on their own, but the New York Times report says the government estimates that more than 10 percent have “low need for round-the-clock assistance.” Also some 217,000 are of working age and many of those could probably do well in a more homelike setting. That represents a large number of residents who might not belong in nursing homes!

Part of the problem is that nursing home residents have no natural advocates. The New York Times quotes Eve Hill from the Department of Justice’s civil rights division, who says “Those people are not in view. We forget about them because they are not in our everyday lives. And that just can’t be the answer. We can’t ignore this.” The Justice Department has brought multiple lawsuits and settled with eight states since 2009 in an effort to force compliance with the Supreme Court decision guaranteeing the rights of the low-income disabled.

Fortunately our state, Washington, is cited as among the more progressive when it comes to alternative care for nursing home residents. The Times reports that ours is among the many states that have concluded that caring for people at home is more cost-effective. “Washington State, for example, has found that its costs for one nursing home resident would pay for home care for seven people,” reports the New York Times.

This article provides a glaring example of something we’ve advocated for years here at AgingOptions. One of the key elements of any comprehensive retirement plan is avoiding unwanted, unplanned institutional care. While sometimes a nursing home or similar facility is the best possible place for an aging person to live, that should never be the “default choice.” There are good, solid, proven ways for you to protect your assets and avoid becoming a burden to your loved ones while preventing being forced to live in a place you don’t want to live, or need to live.

A fully developed LifePlan is the key. A LifePlan provides the blueprint for your retirement years. It assures that you’ve taken into account every facet that will be of critical importance in your senior years: housing choices, financial plans, medical care, legal affairs and family communication. We encourage you to take the first step toward developing a LifePlan for yourself by attending an upcoming LifePlanning Seminar. These information-packed seminars are free, but space is limited. Click on the Upcoming Events tab on this website to find out when and where the next series of LifePlanning Seminars takes place. You can also register for the seminar of your choice.

We’ll look forward to meeting you at an upcoming seminar, and to working with you to develop your LifePlan.

(originally reported at

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