Transitions to long-term and residential care among older Canadians

Abstract

Background: The aging of the Canadian population has increased attention on the future need for nursing home beds. Although current projections rely primarily on age and sex, other factors also contribute to the need for long-term care. This study seeks to identify additional factors to age and sex that contribute to Canadians transitioning from living at home to living in a seniors' residence or nursing home. Data and methods: As part of a larger record linkage project, three cycles of the Canadian Community Health Survey (CCHS) were linked to the 2011 Census of Population: Cycle 3.1 (2005/2006), Cycle 4.1 (2007/2008), and CCHS-Healthy Aging (2008/2009). The sample was limited to successfully linked CCHS respondents who were aged 60 years or older as of Census Day 2011 (May 10, 2011; n=81,411). Sex-specific generalized multinomial logistic regression models were conducted to examine the association between each respondent's characteristics and dwelling location (private dwelling, private dwelling with additional family, nursing home, or seniors' residence) on Census Day. Results: On Census Day, 1.4% of the study sample were living in a nursing home, 1.2% in a seniors' residence, 7.1% in a private dwelling with additional family, and 90.3% in a private dwelling. Women were more likely than men to be living in a nursing home (1.8% of women vs. 0.9% of men) or seniors' residence (1.7% of women vs. 0.7% of men). Regression models showed that, aside from age, there were increased odds of living in a nursing home or seniors' residence among individuals who lost their spouse or who were not married, who did not own their dwelling, who had poor self-rated health, or who had been diagnosed with dementia. The association of other factors with dwelling place differed according to sex and type of dwelling. Interpretation: Although age is strongly associated with living in a nursing home or seniors' residence, other demographic and health factors affect the likelihood of an individual transitioning to an institutional dwelling. Such factors could be considered when planning for the future housing and care needs of the Canadian population.