What Is the Average Stay In a Nursing Home Before Death?
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Most older adults spend their last days in nursing homes or other senior care living facilities. According to a study by the University of California, nearly a quarter (25%) of all deaths in the United States occur in nursing homes, with residents staying an average of 13.7 months before passing away. The average range of stay before death is between 3 months to 1 year. Factors like age, gender, marital status, net worth, and chronic conditions play a role in determining how long seniors remain in nursing homes.
According to the U.S. Census Bureau report, older adults aged 65 or older will outnumber people aged 18 by 2035, which shows the increasing need for senior care facilities.
Key Insights
The average stay in a nursing home at the end of life is around 1 year and 2 months in America, but this can vary based on age, gender, and chronic health conditions.
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Mortality rates among nursing home residents remain higher than pre-pandemic levels.
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Women have longer median stay (8 months) in nursing homes before death than men, whose median stay is just 3 months.
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35% of residents die within the first year of entering a nursing home.
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The most common cause of death among American seniors living in nursing homes is Alzheimer’s or Cardiovascular condition.
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Death in Nursing Home Statistics
According to KFF.org, 1.26M older adults reside in certified nursing home facilities in America as of 2024, which is significantly less than in pre-pandemic years. The resident population decreased by approximately 18% during the first three years of COVID-19. The older adult population fell from 1.32 million in January 2020 to 1.09 million in January 2021 but partially recovered to 1.19 million by the end of 2022.
According to a new study, monthly all-cause mortality rates remained higher than pre-pandemic levels even after accounting for population changes and the introduction of vaccines.
At the peak in December 2020, the adjusted monthly mortality rate was 5,692 deaths per 100,000 residents, compared to 4,778 deaths per 100,000 residents when not accounting for population changes.
- The Centers for Disease Control and Prevention (CDC) estimates that around 24% of all Americans die in nursing homes each year, with many of these deaths potentially preventable through better care practices.
- The average age for entering long-term care facilities is 84 years.
- Entry into nursing homes is usually preceded by months or years of severe disability and escalating caregiving needs.
How Long Do Most People Live In a Nursing Home?
Among older adults, the average length of stay before death is 13.7 months or 1.14 years. Most residents in nursing homes stay for 16 months, according to the Department of Health and Human Sciences. However, the exact estimate depends on various factors such as age, gender, marital status, and chronic conditions.
Average Stay In Nursing Home Before Death Demographics
A study shows the following results on nursing home deaths related to age and gender:
- Residents aged 85 years or older have a median stay of six months, while those younger than 85 years have a median stay of five months in nursing homes.
- Women are more likely (5 months) to live longer than men (3 months) in nursing homes before death.
- Non-Hispanic White residents have a median stay of 5 months in nursing homes, compared to 6.5 months for non-Hispanic Black residents, and 6 months for Hispanic residents.
- The median stay for other racial/ethnic group residents is 2 months.
Life Expectancy Loss in Nursing Homes
Residents in nursing homes have a significantly lower life expectancy compared to those living elsewhere. The average life expectancy loss for nursing home residents is 41 months (3.4 years) even after controlling for pre-existing health conditions. Without any health controls, the life expectancy loss is estimated at 47 months.
- 35% of residents die within the first year of entering a nursing home.
- 16.3% of deaths occur within the first 100 days of their stay in a nursing home facility.
- Residents with no dementia symptoms lose 22 months of life in nursing homes.
- Residents with severe dementia lose 14 months compared to non-nursing home residents with similar health conditions.
- Inefficiencies in care, insufficient staffing, and low quality of services are cited as contributing factors for deaths in nursing homes.
The Leading Causes Of Nursing Home Deaths
According to a study, Alzheimer’s disease is the most common cause of death (36%), followed by cardiac/cerebrovascular issues (30%) and pulmonary causes (23%) in nursing home care facilities. Here’s a breakdown of the leading causes of death among seniors:
Alzheimer’s
Alzheimer’s or other forms of dementia are the most common cause of death among nursing home residents. In the U.S. Alzheimer’s disease ranks 2nd most common cause of death. Residents with dementia require skilled nursing expertise for memory care and well-being.
Cardiovascular Disease
Cardiovascular diseases, including heart attacks and strokes, are a leading cause of death in nursing homes. Older adults often suffer from underlying conditions such as hypertension or arrhythmias, which worsen over time. Limited physical activity and stress in nursing home environments can exacerbate these conditions, increasing the risk of fatal events.
Pneumonia
Respiratory illnesses like pneumonia are common among nursing home residents due to weakened immune systems and chronic conditions. Pneumonia, in particular, is life-threatening for older adults and can develop quickly in communal care settings. Limited mobility and difficulty clearing respiratory secretions further increase vulnerability.
Chronic Diseases
Chronic conditions such as cancer and chronic obstructive pulmonary disease (COPD) are common among nursing home residents. These diseases often progress to advanced stages due to the age and frailty of residents, resulting in higher death rates in nursing homes. 73.8% of residents suffer from high blood pressure, according to a 2020 National Post-acute and Long-term Care Study (NPALS).
Falls and Related Injuries
Falls are a frequent issue in nursing homes, often leading to serious injuries such as hip fractures and head trauma. These injuries can result in complications like infections or immobility, ultimately leading to death. According to the CDC, over 13,700 residents die from falls annually.
Neglect
The National Center on Elder Abuse (NCEA) indicates that neglect accounts for about 11.6% of all instances of nursing home abuse nationwide. Neglect in nursing homes, often due to staff shortages or inadequate care, can lead to severe health issues like malnutrition, infections, or sepsis, resulting in preventable deaths. Vulnerable residents, especially those with cognitive impairments, are most at risk.
COVID-19 Deaths in Nursing Homes by State (2020)
Common Conditions of Residents in Nursing Homes
- Individuals moving into nursing homes are often severely disabled, requiring assistance with at least three activities of daily living (ADLs), such as bathing, dressing, and moving around.
- Nursing home residents receive an average of 27 hours of care per week at home before admission.
- Those entering assisted living facilities are less disabled, receiving about 18 hours of care per week, but their disability levels approach those of nursing home residents within 1-2 years.
Common Chronic Health Conditions Among Nursing Home Residents
According to the CDC National Health Statistics Report (NHS), hypertension is most prevalent among post-acute and long-term care service users in nursing home settings.
Financial Constraints Due To Nursing Home Costs
Nursing home entry is often delayed due to financial constraints or reluctance to place loved ones in such facilities. Many seniors prefer to age at home, using in-home care or hiring care providers.
According to the Genworth Survey of Cost, the median cost of a nursing home facility ranges between $8,500 and $9,700 for a semi-private/private room, which is too expensive for retired seniors.
Distribution of Costs by Type of Room
Medicaid/Medicare for Nursing Homes
Many families rely on Medicare and Medicaid to cover long-term care costs. Around 66% of nursing home residents rely on Medicaid as their primary payer, others either pay by their savings or rely on long-term care insurance.
According to the Milken Institute, around 75% of older adults lack the financial resources to afford current private-pay senior housing options, such as nursing homes and assisted living facilities. This demographic, often referred to as the “Forgotten Middle,” includes seniors who earn too much to qualify for Medicaid but not enough to afford high-quality care.
FAQs
The average person lives 1 year and 2 months after moving into a nursing home, depending on their age, gender, marital status, and chronic condition. Most nursing home residents stay for 16 months, according to the Department of Health and Human Sciences.
The average lifespan also varies based on the quality of health care services provided, the expertise of caregivers, and the overall standards of the nursing home.
The average length of stay in an assisted living facility is 1 year and 10 months. However, this can vary based on gender, age, and health conditions.
To qualify for Medicare coverage in a nursing home, you must follow its eligibility criteria which may include a qualifying hospital stay of at least three consecutive days and require skilled nursing care deemed medically necessary by your provider. Medicare covers up to 100 days of skilled nursing facility care per benefit period but does not cover custodial care if that is the only type of care needed.
Most seniors (70%) aged 65 or older need assistance with some form of long-term care. In terms of gender, women need longer care than men due to their increased life span.
Bottom Line
The average stay in a nursing home before death is 1 year and 2 months, though it varies by demographics. Women have a median stay of 8 months, while men stay for 3 months. Age also plays a significant role, as residents aged 85 or older typically have a median stay of 6 months, while those younger than 85 have a median stay of 5 months.
Severe disability and unpaid caregiving at home often lead seniors to seek care in nursing homes. Care providers must focus on delivering a high-quality level of care and staffing expertise, while government agencies should implement effective care planning to address long-term care needs and improve residents’ quality of life in their final months.
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