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The Outlook for Senior Housing in the Wake of COVID-19

Published: March 23, 2021 | The Senior List Research Team

The COVID-19 pandemic has exacted an enormous toll worldwide, but some communities have been more affected than others. According to one analysis, more than one-third of all U.S. deaths from the virus were in one specific population group — people residing in nursing homes, long-term care facilities, and similar settings.

We wanted to understand whether the pandemic has had lasting effects on how people perceive the health and safety of senior living facilities, so we’ve expanded on research we first conducted in March 2020. That research was released just after news broke about the virus running rampant through those communities.

Here’s a look at the major findings of our research this year and, in some cases, how things have changed over the past year:

  • Despite the pandemic, people are more confident in the health and safety of senior living facilities than they were at this time last year. This is particularly true for those who have first-hand experience with a facility – 40 percent of these people say senior facilities provide “excellent” health safety.
  • Many people do feel that senior living communities mishandled their pandemic response. At the same time, a large majority (68 percent) believe that senior care facilities have adapted and are open to relying on such care in the future.
  • The primary concern for those who feel negatively about senior living facilities? For older adults, it’s the cost (which will continue to rise). For their children, it’s the risk of getting COVID-19 or the flu.

Perceptions of Health Safety

For all respondents, perceptions of the health-related services provided by senior living facilities are looking up. Last year, only 12 percent of all respondents said these facilities provide “excellent” health-related services, and today that number is 17 percent.

Perception of health safety of long-term senior living facilities by year, all respondents*
Perception 2020 2021
Inadequate or poor 20% 15%
Adequate 40% 36%
Good 28% 33%
Excellent 12% 17%

* 2021 includes adults over 75 and younger adults with parent or stepparent over 75, 2020 includes adults over 65 and younger adults with parent or stepparent over 65

People who have experience with senior living communities have better perceptions of these places, whether they are residents or their parents live in such a community, and this was true in 2020 as well. But those without first-hand experience of senior communities saw a higher rate of improvement over the past year.

Last year, about 70 percent of people without first-hand experiences of senior living communities said these places don’t have first-rate health and safety measures. Fewer than one in three said these types of places were “good” or “excellent” when it comes to caring for residents’ health.

Today, while ratings of “good” or “excellent” among this group are still in the minority, they jumped by double digits.

Perception of health safety of long-term senior living facilities by year and residential status*
2020 2021
Sentiment Not in senior living In senior living Sentiment Not in senior living In senior living
Inadequate/
poor
24% 7% Inadequate/
poor
19% 3%
Adequate 46% 22% Adequate 41% 19%
Good 26% 34% Good 32% 38%
Excellent 4% 37% Excellent 9% 41%

* 2021 includes adults over 75 and younger adults with parent or stepparent over 75, 2020 includes adults over 65 and younger adults with parent or stepparent over 65

Polarization of the two groups continued, with 41 percent of people who actually live in these facilities (or family members of those who do) rating them as “excellent” when it comes to ensuring health vs. nine percent of those whose families or selves don’t live in a senior community. This is almost identical to the split in 2020.

It’s important to note that some of this movement may be attributed to a slight difference in the audience we surveyed. Last year, we received responses from those 65 and older (and the children/stepchildren of people in this age group), while this time around, our survey asked about people 75 and older.

This change was made to capture more respondents who are in or closer to the age group most likely to need or want the services provided by senior living communities. People between the ages of 75 and 84 are twice as likely to reside in a nursing home as those 65-74.

Long-Term COVID-19 Impact

Some of the changes in perceptions of nursing homes can also be chalked up to timing. Our first round of the survey was conducted in late March 2020 amid a COVID-19 outbreak at a facility in the Seattle area. Other nursing home outbreaks would soon be reported around the country.

Those fears are well-founded. While residents of long-term care facilities account for only one percent of Americans, about one in three U.S. deaths from COVID-19 have occurred in this population group through early March 2021.

This year, about 51 percent of older adults said the way senior living facilities handled the pandemic has negatively affected their perception of these places. Similarly, a large percentage of those in the younger age group said the same, but their feelings were a bit more subdued with about 43 percent saying their opinion of senior living has been damaged by how the pandemic was handled.

Vaccine rollouts are continuing, and with most states prioritizing older people, the perceptions of the quality of health-related services in nursing homes and other senior communities should continue to improve as uncertainty surrounding the virus recedes.

Indeed, even among people who feel nursing homes bungled their pandemic response, opinions on their potential future in senior living facilities were largely neutral or positive. This was true across both groups – those over 75 and those with parents in the age bracket.

Likelihood of future use of senior living community among respondents whose opinion of senior facilities was damaged by pandemic response
Prediction Adults 75+ Adult children
Yes 36% 38%
Neutral 30% 31%
No 34% 32%

There is no consensus view in either age group about whether senior care facilities are in their family’s future. But in both cases, the most common response was that either they or their parents would reside in a senior facility at some point — even though they all believed nursing care and other facilities mishandled the pandemic.

However, for those who rated senior living facilities poorly, COVID-19 and other infectious diseases, such as influenza, are a big worry. Importantly, though, cost is the biggest factor for people who said senior facilities don’t provide “good” or “excellent” care. (How much do nursing homes cost?)

Primary concern among respondents who rated senior living facilities as anything other than “good” or “excellent”
Cost of living in a senior long-term care facility 45%
COVID-19 or influenza infection 30%
Lack of adequate senior living facilities in area 13%
Lack of socialization 10%
Other 3%

Those over 75 who rated nursing home health quality as less-than-good are far more concerned about finances than are those who have parents in that age group. For 58 percent of this group, cost is the biggest worry.

Primary concern among respondents who rated senior living facilities as anything other than “good” or “excellent”
Concern Adults 75+ Adult children
Cost of living in a senior long-term care facility 58% 28%
COVID-19 or influenza infection 22% 39%
Lack of adequate senior living facilities in your area 10% 16%
Lack of socialization 7% 14%
Other 2% 3%

Among those who aren’t currently involved with senior living communities, few respondents are dead-set against using senior care in the future. Notably, though, adult children are slightly more enthusiastic about the prospect and vice-versa.

Likelihood of future use of senior living community
Prediction Adults 75+ Adult children
Yes 38% 42%
Neutral 28% 31%
No 34% 27%

Conclusion

Just over a million people 65 and older live in nursing homes, assisted-living facilities, and similar communities. Quality care is essential to the health and happiness of people who reside in these places, both for themselves and their families.

Methodology

To understand Americans’ perceptions of senior living communities, including assisted living and nursing homes, we surveyed a total of 1,243 people in two age groups (those 75 and older and those under 75 who have a parent or stepparent in that age group) about their views on the health safety of senior communities. Our surveys were conducted online in March 2021.