These conditions result in people becoming dependent on others in performing the activities of daily living. The need for personal assistance with everyday activities increases with age. The elderly cannot always rely on family and friends. Family sizes have been getting smaller, family members are often dispersed across the country, and many women work outside the home. The traditional support from family members is often not available.
Nutrition is a concern.
Adequate nutrition is a concern for many elderly, but especially for those who live alone and are frail. Medicaid reimbursements have not kept pace with costs. Medicaid long-term care reimbursements have been increasing, but the rate of increase has been declining since fiscal year 1996. Total Medicaid long-term care reimbursements increased 12.5 percent in fiscal year 1998, down from the 16 percent and 25 percent increases in fiscal years 1997 and 1996, respectively. Thus, more people have looked for alternatives such as in-home care or community services.