The Geographical Location Of Nursing Homes: How Accessible Is Care In Our Ageing Society

Abstract Background With ageing demographics, the demand for residential nursing care is increasing. Some evidence and anecdotal experience suggests that nursing home care is often not available locally, resulting in individuals moving from their homes, communities and psychosocial support systems. Methods To evaluate if residential care in Ireland meets demand the number of residential care beds per 1000 adults>65years were estimated from publicly available data. Persons who sought access to the nursing home support scheme over a 6month period were reviewed. Their home location and nursing home location were analysed with respect to locality (city/suburban/town/rural), distance (km), travel time (minutes) and public service networks. Ethically approved. Results Nationally, the lowest availability of nursing home beds was Wicklow and highest Longford. Galway has 0.90 nursing home beds per1000 adults >65years. Of 262 consecutive cases presented to one local placement forum between July–December2023, 133 availed of the scheme and were resident in a nursing home at 3month follow-up. Exclusions included remained at home, deceased, or unknown. Nursing home location was city 6%(n=8), suburb 21%(n=28), town 16.5%(n=22) or rural 56%(n=75). All city placements were public. Drving distance from home to nursing home was 15km (IQR7,31) with a car driving time of 18mins (IQR11,35). No public transport service link from home to nursing home for visiting purposes was available to 38%(n=51), and when available incurred more than one bus change in 65.2%. City dweller was residing in a city located nursing home in 13%(n=5). Of the 87%(n=33) relocated out of the city, over half (n=19) were to rural locations (p