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Nursing Home or Village?

nursinghomevillageA recent report from the Congressional Budget Office created a bit of a stir among geriatric care managers, because it predicted that the dollars spent on nursing homes and longer term care will amount to 3.3 percent of gross domestic product (GDP) by the year 2050.  It is true that in the most recent year for which there is data, Americans spent $192 billion on these living environments, or about 1.3 percent of GDP.

This past May, the National Association of Professional Geriatric Care Managers asked its members if we had an opinion on older adults moving into nursing homes in such numbers. However, there are alternatives:

  1. The best thing older adults can do is make a plan.  We all make vacation plans and maybe even retirement plans; we need to make plans around aging in place while still preserving quality of life.
  2. Next in line is taking stock of home.  It is easy to not see that the home in which parents raised a family just doesn’t work as well for older adults who may have some mobility issues – hint: an elder care manager can help.
  3. With an objective picture of the home layout, set about making home a safer and easier place to live than it is now.  Grip bars in a bath room, extra lighting in the halls and ramps instead of stairs can be a start.
  4. And it is important to remember who actually is going to live in the home.  Well-intentioned children of older parents may want to come in and do a “home-makeover,” but it is really important to help mom or dad lead the team.
  5. And just as it takes a village to raise a child, there are resources and people in your older parents’ community who can provide support.  If you don’t know what services or agencies can be brought in, again ask a professional.  (We also have some listed on our “Support Tools” page of this web site.)


Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.  Please email your questions to


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