A shift among where older adults receive care is taking place, according to a recent study published in The Milbank Quarterly. The number of people living in residential care settings other than nursing homes is growing.

Nearly 3 million older Americans received assistance with three or more self-care or mobility activities in settings other than nursing homes.

“With continuing care shifts away from nursing homes, strategies are needed to improve community-based long-term care services and supports to aid both older adults and the informal caregivers who provide most care,” the study says.

Altogether, one in four older adults receiving help lived in either a supportive care (15%) or a nursing home (10%) setting.

The age-in-place boom is also spurring home health job growth.

Today, about one in five older people with limitations in activities of daily living report need more help than what is received.

Nearly one-half of older adults, or 18 million people, had difficulty or received help in the last month with daily activities — and of those adults nearly all of them received informal caregiver care, and about three in 10 received paid care.

“The older population—especially those with few economic resources—has substantial late-life care needs,” the study concludes. “Policies to improve long-term services and supports and reduce unmet need could benefit both older adults and those who care for them.”

The study was based on the 2011 National Health and Aging Trends Study, a national panel study of more than 8,000 Medicare enrollees.

Access the study here.

Written by Cassandra Dowell