Mature Asian woman spending quality time with her depressed elderly mother at home.
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People living with dementia are more likely to choose aging in place over an assisted living or a continuing care retirement community, according to a new study.

A research letter in the Journal of the American Geriatrics Society reported that over the last two decades, a variety of factors have shifted where people with dementia live, including family caregiver availability, declining marriage and birth rates, alternative residential care arrangements, Medicaid expansion of home- and community-based services and the long-term care workforce crisis.

Researchers said their study showed that the COVID-19 pandemic noticeably altered living arrangements for individuals living with dementia, increasing the number of those opting to age in place.

Using data from the National Health and Aging Trends Study, researchers found that between 2015 and 2021, the proportion of people living with dementia who resided alone increased sharply during the pandemic, from 16% in 2015 to 22% in 2021. The proportion of people with dementia living in a residential care setting, including assisted living and CCRCs, remained steady at 17%, while those living in nursing homes increased from 6% in 2015 to 15% in 2019 before declining during the pandemic.

What concerned researchers was increasing functional impairment and levels of unmet needs among those living alone or in a residential care setting, including assisted living and CCRCs, “given the limited regulatory oversight and lack of uniformity in services available in these settings.”

“It is vital that policymakers and providers identify effective strategies for ensuring an adequate level of support and care for [people living with dementia], regardless of their living arrangement,” the authors concluded. 

Researchers from the University of Pennsylvania said future work should examine whether this was a temporary response to COVID-19 infection concerns or a continuing trend. 

The study was supported by a grant from the National Institute on Aging.