Nursing Home Avoidance Escalates Level of In-Home Senior Care

Family caregivers are escalating the level of care they’re providing in an effort to keep their loved ones at home and out of the nursing home, according to a new AARP report, and nearly a quarter of those are doing so without the help of a trained professional.

The level of care that non-professional caregivers are providing has grown increasingly complex to include services that were once only provided in hospitals. Almost half of family caregivers (46%) performed medical/nursing tasks for care recipients with multiple chronic physical and cognitive conditions, the AARP Public Policy Institute and United Hospital Fund survey revealed. 

“Those who provided these tasks and reported they had training were more likely to say they were able to help their family member avoid nursing home placement,” says the AARP report.


Tasks can include medication management, helping with assistive mobility devices, preparing food for special diets, providing wound care, using monitors, managing incontinence, and operating specialized medical equipment, along with assistance with activities of daily living. 

However, more than half of those who performed five or more medical/nursing tasks reported feeling down, depressed, or hopeless in the last two weeks, says AARP, suggesting that taking on these responsibilities may be beyond what many nonprofessional senior caregivers are capable of on a sustainable basis. 

“The family caregivers in our survey reported that their chronically ill family members were in and out of hospitals and emergency departments. Despite frequent encounters with the acute care system, family caregivers were not prepared for the medical and nursing tasks they were expected to provide at home,” said Carol Levine, Director of Families and Health Care Project for United Hospital Fund, in a statement.


Healthcare provider organizations, including rehab centers and nursing homes, need to support healthcare professionals in their efforts by providing adequate resources and strong leadership, AARP recommends. 

“Every provider should have clear expectations, protocols, and support for clinicians who interact with family caregivers, especially caregivers who are taking on complex medical/nursing tasks. Payment policies should be structured to make this happen,” says the report.

Access the full report

Written by Alyssa Gerace