Is There an Alternative to the Nursing Home for North Carolina's Elderly?

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Cooper, Lynne Eickholt
- Affiliation: College of Arts and Sciences, Department of City and Regional Planning

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The majority of North Carolinians can look forward to a long life, unthreatened by major epidemics of communicable disease and malnutrition. But even though most of us will reach the age of 65, it is likely we will be frustrated with one or more chronic conditions that will restrict the pleasures of normal activity. The present medical system, focused on the acute episode of illness, is poorly equipped to deal with the health needs of the chronically ill elderly. The medical system has run them in and out of expensive general acute care hospitals and discharged them, often disabled, with no provision for care other than family endeavors. When the burden of caring for an elderly family member, the long term institution is often the only resort. Institutionalization is an expensive answer to the problems of the long termed disabled. North Carolina spent over 10 million dollars in state Medicaid contributions in fiscal year 1975 to support the elderly in long term skilled and intermediate care facilities. This fact coupled with the realization that institutionalization can be a demeaning and hopeless way to spend one's last years have spawned an interest in two alternatives-home health and geriatric day care. Both programs are aimed at allowing the aged the option of remaining in the community by supplementing family support for aged members. This article attempts to analyze the three alternatives as they operate in North Carolina, from a cost effectiveness point of view.

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