Nursing Home Stays and the Pace of Severe Disability Onset

Abstract

Severe disability is an important predictor of nursing home admissions. The purpose of this study is to examine the role of severe disability pacing on risk of short- and long-term nursing home stays. Respondents who developed severe disability were assigned into one of two pacing trajectories: catastrophic or progressive disability. The author analyzed seven waves of data from the Health and Retirement Study and created a series of discrete-time event history models. The analysis showed that the risk associated with severe disability and nursing home stays varied based on severe disability pacing. Progressive and catastrophic disability were associated with increased risk of short- and long-term stays; however, the risk of nursing home stays was much greater for respondents with catastrophic disability for short- and long-term stays. The findings have implications for policy and research. The author suggests that future research focus on interventions aimed at slowing the pace of severe disability.