What are the odds of ending up in a nursing home?

I’m making my way through Never Say Die, Susan Jacoby’s screed against the perky marketing of “the new old age.”   More on that soon, much more, but it’s in her first chapter that I found the following statistics, from Muriel Gillick’s The Denial of Aging:  “The latest prediction is that if you are just now turning 65, you have nearly a 50 percent chance of spending some time in a nursing home before you die.  Approximately 10 percent of those nursing home stays will be short-term, intended for recuperation after a hospitalization. The remainder will be for the long haul, with discharge to a funeral parlor, not to the family home.”

The statistic I’ve quoted —  that only four percent of the over-65 population, down from 5% over the last decade — lives in nursing homes, is also correct, and Jacoby cites it as well, along with the fact that anyone over 85 has about a 50/50 chance of ending up in a nursing home. Where I take issue is with Jacoby’s inference that the second statistic is brushed under the rug as part of the overweening American tendency to sugarcoat the brutal realities of late life. “Needless to say, it is much more comfortable and comforting to think about the wellderly than about the invisible illderly in nursing homes,” she writes.

The invisibility of the old in this society is indeed a massive problem. Segregation fuels discrimination. But the healthy old are almost as invisible in their retirement community rec rooms, the home-bound frail equally unseen as those in institutions. And I’d wager that most baby boomers have no trouble at all conjuring up those linoleumed hallways, whether recalled from visits to parents and grandparents or merely the stuff of bad dreams. I’m pretty sure that ending up in a nursing home is most people’s worst fear about getting old, paired with Alzheimer’s, its evil twin. (Dementia is what necessitates residential care for a huge percentage of the old old.) It’s no shocker that the odds increase the older we get; the two sets of numbers coexist just fine. The problem is that our terror prevents a clear-headed look at all the eventualities, both uplifting and dreadful, that these statistics represent.