A descriptive study of housing preferences for persons with disabilities living in nursing homes in Dunn County

Abstract

This descriptive study replicated a Chicago study concerning housing issues for individuals with disabilities conducted by Access Living and The Center for Urban Research and Learning, Loyola University (Kruger, 2000). The trend for individuals with disabilities is to be able to choose to live independently and to receive community services to support that choice. Unfortunately, many people capable of living in other housing arrangements still live in nursing homes. Individuals are being placed in nursing homes for reasons including: onset of disability, placement after a hospital stay, homelessness; housing conditions (not accessible, inadequate, substandard, filthy, unaffordable, or unsafe) or because of lack of access to personal care services at home. Other states have initiated Medicaid waivers so that nursing home residents can make a transition from nursing homes to Medicaid supported community-based care. Previous studies showed that with federal dollars and community services, individuals with disabilities can live more independently and enjoy a better quality of life, and such placement also saves taxpayers' dollars. The specific purpose of this study was to determine if housing problems existed in a rural setting such as Dunn County, Wisconsin and if those problems were identical to or different from the problems in an urban area such as Chicago. An on-site survey of residents in the three nursing homes in Dunn County was conducted. A gap in the literature was addressed by examining rural nursing home placement, disability, daily life activity limitations and self-reported reasons for nursing home placement. Results showed over 60% of residents did not want to move into a nursing home. The most common reason for nursing home placement, reported by almost two thirds of respondents (63.6%), was the inability to care for self. Other reasons included being afraid that something bad would happen (39.4%), being unable to care for own home/apartment (33.3%), inability to pay bills (12.1%) and lack of transportation (8.2%). Some individuals (36.4%) chose to move into the nursing home. Survey participants were equally divided when asked if they felt that they could reside more independently. Preferred independent residencies included small apartments, and small group homes; residences in close proximity of others. Many of the individuals who did not report a disability reported a functional limitation. The most common life activity problem was transportation (63.3%). Bathing, housekeeping, walking, shopping taking medications and laundry (30% to 45%) were all life activities requiring assistance according to individuals that participated. Such activity barriers constrain residential choice. Individuals with disabilities and functional activity barriers in Dunn County could live more independently with community supports such as home health. Individuals with disabilities should be offered informed choices and alternative housing alternatives prior to nursing home placement. Self-report by individuals with disabilities in both the Dunn County study and the Chicago study indicate that independent residency is a preferred choice, but that there are many barriers that prevent individuals with disabilities from residing independently.