Duration of stay and other aspects of nursing home use

In 1965, the Human Population Laboratory (California State Department of Health Services) conducted a survey of the non-institutionalized population of Alameda County. Subsequent checking of death records disclosed that 521 survey participants aged fifty-five years or over in 1965 had died by January, 1975. A follow-up in 1977-78 of nursing home experience among these decedents revealed that about two-fifths of those for whom information could be obtained (N = 455) had entered a nursing home at least once in the nine-year follow-up period. Further inquiry located 158 cases whose experience of institutionalization before their death could be reconstructed. Among these cases, only 22 per cent ever returned home or transferred to a residential facility after being institutionalized. Most persons died after the first admission, at the nursing home itself or at an acute care hospital to which they had been transferred shortly before death. Among the cases whose experience of institutionalization could be reconstructed, five out of ten spent less than three months, and six out of ten spent less than six months, as patients in nursing home(s). However, nearly 30 per cent of the 158 cases with reconstructed histories accumulated patient-days exceeding a year.