How Housing Influences Nursing Home Utilization in the United States: An Integrative Review

Area of Science:

• Gerontology
• Public Health
• Sociology

Background:

• The housing crisis is increasing focus on housing as a determinant of nursing home utilization.
• Pathways linking housing to nursing home use require clarification.

Purpose of the Study:

• To delineate the mechanisms through which housing influences nursing home utilization in the United States.

Main Methods:

• An integrative review of 16 articles published after 1999.
• Data synthesis employed a constant-comparative approach.
• Studies focused on individuals at risk for nursing home placement or continued use.

Main Results:

• Housing influences nursing home use through three key themes: financial asset vs. strain, needs-housing mismatch, and compounding systemic inequities.
• Financial strain from housing increases nursing home risk.
• Evolving functional needs misaligned with housing environments can lead to nursing home placement.
• Socioeconomic disparities linked to housing exacerbate nursing home utilization risks for marginalized communities.

Conclusions:

• Evidence confirms housing's role in nursing home utilization, but requires strengthening due to limited evidence quality and methodological diversity.
• Clinicians, researchers, and policymakers must acknowledge housing's significance.
• Interventions should target improved housing conditions for older adults and individuals with disabilities.